Figure.

Myocardial MME gene expression is higher in patients with oHCM at septal myectomy versus controls using A) microarray (N=106 oHCM and N=39 controls) and B) RNAseq (N=18 oHCM and N=5 controls). C) Higher myocardial MME gene expression is specific to fibroblasts in patients with end-stage nHCM (N=15) and DCM (N=11) at the time of transplant compared to controls (N=16). D) Higher myocardial MME expression in patients with both HFpEF (N=41) and HFrEF (N=30) compared to controls N=30), with MME expression being significantly higher in HFrEF compared to HFpEF (P=4.88E-7). Note, the data in B-D are presented as Log2 Fold Change Compared to Control, hence, there are no bars for control groups. In the VUMC cohort of patients with oHCM (N=36), MME expression is higher using qPCR (E) compared to controls (N=8). The increase in MME expression parallels higher NEP concentration (using AlphaLISA, PerkinElmer) and activity (using solid-phase activity assay) compared to controls (E-G). Collectively, these data indicate convergence of MME transcription is a feature of cardiomyopathy independent of etiology, and NEP may be a viable therapeutic target in patients with HCM. For panels A and E-G, t-test or Mann-Whitney U test were used when appropriate. Details regarding statistical analyses for panels B-D can be found in references 3–5. Data are presented as mean ± standard deviation where error bars are present.