TGFB1 and Myocardial fibrosis: One of the possible explanations is that MYH7 mutations cause imbalance in the expression of intercellular variant/normal proteins, generating inconsistent contractile forces that lead to disordered myocardial arrangement and interstitial fibrosis through TGF-β/Smad signaling pathway.17,18 This mutation also causes increased collagen synthesis and deposition, resulting in a higher risk of myocardial fibrosis.18