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Hcy is implicated in cardiovascular disease through diverse mechanisms, including the heightened proliferation of muscle cells leading to vessel constriction, modification of blood coagulation properties, oxidative damage to the vascular endothelium, and harm to arterial walls [49]

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GATA4 , a critical transcription factor involved in cardiac hypertrophy, is upregulated by 0.193 log2 (fold change), further supporting the link between metabolic dysregulation and hypertrophic remodeling in PRKAG2 cardiomyopathy