TGFB1 and endothelial dysfunction: Different factors could play a role in the association between aortic pathology and HCM: TGF-β (transforming growth factor-beta) overexpression, neurohormonal disturbance, endothelial dysfunction, and an abnormal baroreceptor response of the LV.3.6For all these reasons, an exclusive subset of patients with both OHCM and aortic aneurysm could be at higher risk for adverse events such as aneurysm rupture and dissection.