Further, our observations suggest that an elevated heart rate in FSHD may be indicative of physical inactivity or deconditioning, which may put this group at risk for future CVD or cardiac events, but this appears to be secondary to FSHD or overexpression of the DUX4 gene mutation, as we did not observe alterations in autonomic function in this group. Here, DUX4 is linked to Facioscapulohumeral dystrophy.