Increased expression and elevated levels of matrix metalloproteinase-2 (MMP-2) and MMP-9 play a role in impaired cardiac function. These MMPs make for essential targets in the treatment of heart failure, specifically heart failure with preserved ejection fraction (HFpEF).

Calcium/calmodulin-dependent protein kinase II (CaMKII) is involved in the regulation of calcium and its hyperactivation can lead to cardiac issues, particularly with rhythm and contraction.