HMGCR and heart failure: Our study of four previous reports of cardiac involvement in anti-HMGCR antibody myopathy found that all of these patients had heart failure in the form of systolic and diastolic dysfunction, with only one patient presenting with ECG abnormalities and elevated troponin I levels (9, 18–20); a more recent retrospective study found that 11 of 36 anti-HMGCR antibody-positive patients had left ventricular diastolic dysfunction and 6 showed systolic dysfunction.