It was first reported in pediatric cardiomyopathy that patients with biallelic truncating genetic variants in ALPK3 (ALPK3tv) displayed a phenotype of dilated cardiomyopathy (DCM) in utero, at birth, or early childhood, and often evolved to an HCM phenotype over time (4, 5). This evidence concerns the gene ALPK3 and cardiomyopathy.