TBX20 protein presents strong transcriptional activation and repression domains, and it interacts physically, functionally, and genetically with other cardiac developmental transcription factors, including NKX2-5, GATA4, GATA5, GATA6, and TBX5, which are associated with CHD and have also been linked to DCM/LVNC in recent years.22–26 Different growth factors involved in cardiac chamber development, ventricular trabeculation, and valvulogenesis upregulate and downregulate TBX20 expression. This evidence concerns the gene TBX20 and left ventricular noncompaction.