In pre‐clinical studies, MFAP4 has been implicated in remodelling and myocardial fibrosis28, 29 and MFAP4 levels have previously been associated with risk of cardiovascular diseases relevant to HFpEF pathophysiology, including atrial fibrosis, atrial fibrillation, and pulmonary hypertension.30 This evidence concerns the gene MFAP4 and pulmonary arterial hypertension.