These increased inflammatory markers are postulated to lead to myocardial fibrosis and worse outcomes in patients with HFpEF and DM. It is worth noting that in 2013, the American College of Cardiology Foundation/American Heart Association's (ACCF/AHA) heart failure guidelines recommended the use of two myocardial fibrosis markers, galectin-3 and soluble ST2, for risk stratification with Class IIb recommendations [26]. This evidence concerns the gene LGALS3 and Myocardial fibrosis.