MME and ischemic cardiomyopathy: The regulation of NEP expression in HF is part of an ongoing discussion, as an early study found NEP upregulation in human ventricular cardiomyocytes in patients with aortic stenosis and HF (10), while a more recent study in a porcine model of ischemic cardiomyopathy suggested a systemic downregulation of total NEP expression (11).