In mice, piRNAs have been previously described to play roles in regulation of mRNA in CVD, including regulation of acetylation of transcription factor Tfec mRNA involved in cardiomyocyte death after myocardial infarction, suppressing methylation of Atf7 mRNA to regulate necroptosis in cardiomyocytes, playing a role in advancing cardiac fibrosis through direct inhibition of Apln mRNA in cardiac fibroblasts, and regulating cardiac hypertrophy through controlling methylation of Parp10 mRNA [52–55]. Here, APLN is linked to cardiac hypertrophy.