RT-qPCR analysis showed marked upregulation of cardiac stress markers (nppa, nppb), contractile dysfunction-related genes (myh7, tnnt2, mybpc3) and a gene related to fatty acids metabolism (ppara) in the H group (Figure 2G), consistent with pathological hypertrophy and cardiomyopathy progression [24]. Here, NPPA is linked to cardiomyopathy.