To date, only zDHHC9 has been implicated in cardiac pathophysiology and adaptation, where it represses atrial natriuretic peptide release via S-palmitoylation of Rab3gap1 and impairment of the Rab3 GTPase cycle, and sustained zDHHC9 overexpression in cardiomyocytes ultimately results in dilated cardiomyopathy in late adulthood (95). Here, NPPA is linked to dilated cardiomyopathy.