In vitro studies have shown an association between Cer synthesis via CERS5 and cardiac hypertrophy and autophagy.70, 71, 72 Interestingly, our findings suggest an association between higher levels of dhCer(16:0) and lower ΔLVEDD in nonresponders, as well as an association between lower levels of dhCer(16:0) and increased ΔLVEF in responders. This evidence concerns the gene CERS5 and cardiac hypertrophy.