APN protects the cardiomyocyte primarily by inhibiting extracellular signal-related kinases, activating adenosine monophosphate-activated protein kinase signaling in the myocardium, inhibiting cardiomyocyte hypertrophy or activating macrophage autophagy, and reducing cellular inflammation in the DCM rat model [22]. Here, ANPEP is linked to familial dilated cardiomyopathy.