Consistently, Sabbah et al. observed decreased levels of fusion-associated proteins (Mfn2 and OPA-1) concomitant to increased levels of fission-associated proteins (Fis-1 and Drp1) in left ventricular tissue from dogs and humans with HF (idiopathic dilated cardiomyopathy or ischemic cardiomyopathy), that were reverted by a long-term therapy with elamipretide (ELAM), a water-soluble tetrapeptide targeting mitochondrial dynamics [156]. The gene discussed is OPA1; the disease is hydrops fetalis.