Transforming Growth Factor Beta-1-Induced Transcript 4 Protein (Tsc22; upregulated in MCT RV: protein = 3.82-fold, transcript = 2.1-fold) Tsc22 regulates alpha smooth muscle actin, PAI-1, fibronectin and collagen I, contributing to myocardial fibrosis (Yan et al., 2011). Here, TSC22D1 is linked to Myocardial fibrosis.