GLA and heart failure: Deficiency or absence of alpha-galactosidase A (α-Gal A) enzyme activity leads to the accumulation of glycosphingolipids, specifically globotriaosylceramide (GL-3), in lysosomes leading to various symptoms and signs such as neuropathic pain, gastrointestinal manifestations, renal failure, hypertrophic cardiomyopathy and fibrosis, cardiac rhythm disturbances, heart failure, and stroke.