In a recent study, out of 101 patients with MVP predominantly of Barlow type who underwent extensive gene testing, eight patients (8%) had a likely pathogenic variant in four cardiomyopathy genes (DSP, HCN4, MYH6, and TTN), in favor of a common genetic origin for both myocardial and MV disease (53) but we cannot rule out a chance association. Here, HCN4 is linked to familial mitral valve prolapse.