Moreover, IL-33/IL1RL1 signaling could activate TGF-β-mediated fibroblast activation and epithelial-mesenchymal transition in the myocardium, promoting extracellular matrix (ECM) production, thereby driving myocardial fibrosis and structural remodeling characteristic of HCM (Zhu et al., 2023). This evidence concerns the gene TGFB1 and Myocardial fibrosis.