We observed up-regulation of Nppa in pre-symptomatic cMKO mice, which was associated to up-regulation of Nppb at the onset of DCM, prototypical cardiomyocyte stress-response genes that are activated in response to hemodynamic load38 and metabolic or contractile abnormalities39 (Fig. 1p). This evidence concerns the gene NPPB and familial dilated cardiomyopathy.