PRDM11
geneOn this page
Also known as PFM8
Summary
PRDM11 (PR/SET domain 11, HGNC:13996) is a protein-coding gene on chromosome 11p11.2, encoding PR domain-containing protein 11 (Q9NQV5). May be involved in transcription regulation.
Predicted to enable DNA-binding transcription factor activity; RNA polymerase II cis-regulatory region sequence-specific DNA binding activity; and chromatin binding activity. Involved in several processes, including negative regulation of cell growth; positive regulation of fibroblast apoptotic process; and regulation of DNA-templated transcription. Located in cytosol and nucleus.
Source: NCBI Gene 56981 — RefSeq curated summary.
At a glance
- GWAS associations: 26
- Clinical variants (ClinVar): 11 total
- Druggable target: yes
- MANE Select transcript:
NM_001384648
Identifiers
Gene identifiers
| Field | Value |
|---|---|
| HGNC ID | HGNC:13996 |
| Approved symbol | PRDM11 |
| Name | PR/SET domain 11 |
| Location | 11p11.2 |
| Locus type | gene with protein product |
| Status | Approved |
| Aliases | PFM8 |
| Ensembl gene | ENSG00000019485 |
| Ensembl biotype | protein_coding |
| OMIM | 616347 |
| Entrez | 56981 |
Gene structure
Transcript identifiers
Ensembl transcripts: 7 — 6 protein_coding, 1 protein_coding_CDS_not_defined
ENST00000424263, ENST00000528980, ENST00000530656, ENST00000534751, ENST00000622142, ENST00000683152, ENST00000959457
RefSeq mRNA: 7 — MANE Select: NM_001384648
NM_001256695, NM_001256696, NM_001359633, NM_001384648, NM_001384649, NM_001384650, NM_001384651
CCDS: CCDS58130, CCDS73277, CCDS91463
Canonical transcript exons
ENST00000683152 — 8 exons
| Exon | Start | End |
|---|---|---|
| ENSE00000711598 | 45182861 | 45183123 |
| ENSE00001300816 | 45224217 | 45224843 |
| ENSE00001324832 | 45182246 | 45182349 |
| ENSE00002168602 | 45146639 | 45146877 |
| ENSE00003474412 | 45204711 | 45204778 |
| ENSE00003617000 | 45219570 | 45219757 |
| ENSE00003659674 | 45181761 | 45181885 |
| ENSE00003922067 | 45225995 | 45235109 |
Expression profiles
Bgee: expression breadth ubiquitous, 214 present calls, max score 87.62.
FANTOM5 (CAGE): breadth ubiquitous, TPM avg 3.5778 / max 45.8352, expressed in 1463 samples.
FANTOM5 promoters (3 alternative TSS)
| Promoter ID | TPM avg | Samples expressed |
|---|---|---|
| 114017 | 2.6313 | 1256 |
| 114018 | 0.6963 | 393 |
| 114019 | 0.2502 | 153 |
Top tissues by expression
242 total, by Bgee expression score (0-100, higher = more expressed):
| Tissue | Anatomy ID | Expression score | Quality |
|---|---|---|---|
| epithelial cell of pancreas | CL:0000083 | 87.62 | silver quality |
| descending thoracic aorta | UBERON:0002345 | 85.06 | gold quality |
| thoracic aorta | UBERON:0001515 | 84.14 | gold quality |
| ascending aorta | UBERON:0001496 | 84.03 | gold quality |
| aorta | UBERON:0000947 | 83.35 | gold quality |
| germinal epithelium of ovary | UBERON:0001304 | 83.08 | gold quality |
| popliteal artery | UBERON:0002250 | 82.87 | gold quality |
| right coronary artery | UBERON:0001625 | 82.84 | gold quality |
| tibial artery | UBERON:0007610 | 82.83 | gold quality |
| lower esophagus muscularis layer | UBERON:0035833 | 82.56 | gold quality |
| lower esophagus | UBERON:0013473 | 82.50 | gold quality |
| esophagogastric junction muscularis propria | UBERON:0035841 | 82.41 | gold quality |
| body of uterus | UBERON:0009853 | 82.39 | gold quality |
| endothelial cell | CL:0000115 | 82.00 | silver quality |
| primary visual cortex | UBERON:0002436 | 81.93 | gold quality |
| sural nerve | UBERON:0015488 | 81.87 | gold quality |
| left coronary artery | UBERON:0001626 | 81.72 | gold quality |
| mucosa of stomach | UBERON:0001199 | 81.52 | gold quality |
| coronary artery | UBERON:0001621 | 81.29 | gold quality |
| apex of heart | UBERON:0002098 | 81.23 | gold quality |
| right atrium auricular region | UBERON:0006631 | 81.23 | gold quality |
| cardiac atrium | UBERON:0002081 | 80.86 | gold quality |
| muscle layer of sigmoid colon | UBERON:0035805 | 80.72 | gold quality |
| smooth muscle tissue | UBERON:0001135 | 80.43 | gold quality |
| left uterine tube | UBERON:0001303 | 80.28 | gold quality |
| heart left ventricle | UBERON:0002084 | 80.26 | gold quality |
| pigmented layer of retina | UBERON:0001782 | 80.18 | gold quality |
| prefrontal cortex | UBERON:0000451 | 80.07 | gold quality |
| ectocervix | UBERON:0012249 | 79.83 | gold quality |
| right ovary | UBERON:0002118 | 79.82 | gold quality |
Single-cell (SCXA)
Detected in 1 experiment(s), a significant marker in 0.
| Experiment | Marker? | Max mean expression |
|---|---|---|
| E-ANND-3 | no | 3.60 |
Regulation
Is transcription factor: yes
Downstream targets (CollecTRI)
3 targets.
| Target | Regulation |
|---|---|
| FOS | Repression |
| JUN | Repression |
| VAV3 | Repression |
Literature-anchored findings (GeneRIF, showing 1)
- We characterize PRDM11 as a putative novel tumor suppressor that controls the expression of key oncogenes, and we add new mechanistic insight into B-cell lymphomagenesis. (PMID:25499759)
Cross-species orthologs
3 orthologs
| Organism | Symbol | Gene ID |
|---|---|---|
| danio_rerio | prdm11 | ENSDARG00000074468 |
| mus_musculus | Prdm11 | ENSMUSG00000075028 |
| rattus_norvegicus | Prdm11 | ENSRNOG00000008674 |
Paralogs (1): PRDM7 (ENSG00000126856)
Protein
Protein identifiers
PR domain-containing protein 11 — Q9NQV5 (reviewed: Q9NQV5)
All UniProt accessions (3): A0A087WWZ6, Q9NQV5, H3BSZ2
UniProt curated annotations — full annotation on UniProt →
Function. May be involved in transcription regulation.
Subcellular location. Nucleus. Cytoplasm.
Tissue specificity. Highly expressed in lung, including bronchial epithelial cells and airway smooth muscle cells, as well as in peripheral blood mononuclear cells. In tonsils, expressed in B-cell types, including naive B-cells, centroblasts, centrocytes and memory B-cells (at protein level). In benign hyperplastic lymph nodes, expressed in germinal center cells in both the dark and light zones, as well as in scattered cells in the mantle zone and the interfollicular area (at protein level).
Polymorphism. A genome-wide association analysis shows PRDM11 association with forced vital capacity (FVC), a spirometric measure of pulmonary function, that reflects lung volume and is used to diagnose and monitor lung diseases.
Similarity. Belongs to the class V-like SAM-binding methyltransferase superfamily.
Isoforms (2)
| UniProt ID | Names | Canonical? |
|---|---|---|
| Q9NQV5-1 | 1 | yes |
| Q9NQV5-2 | 2 |
RefSeq proteins (7): NP_001243624, NP_001243625, NP_001346562, NP_001371577, NP_001371578, NP_001371579, NP_001371580 (=MANE)
Domains & families (InterPro)
| ID | Name | Type |
|---|---|---|
| IPR001214 | SET_dom | Domain |
| IPR044405 | PRDM11_PR/SET | Domain |
| IPR046341 | SET_dom_sf | Homologous_superfamily |
| IPR050331 | Zinc_finger_PRDM4/PRDM1/PRDM14 | Family |
Pfam: PF21549
UniProt features (34 total): strand 12, cross-link 5, turn 4, sequence conflict 3, helix 3, sequence variant 2, chain 1, domain 1, region of interest 1, modified residue 1, splice variant 1
Structure
Experimental structures (PDB)
1 structures.
| PDB | Method | Resolution (Å) |
|---|---|---|
| 3RAY | X-RAY DIFFRACTION | 1.73 |
Predicted structure (AlphaFold)
| Model | pLDDT | Fraction very-high |
|---|---|---|
| AF-Q9NQV5-F1 | 61.94 | 0.25 |
Functional residue map
Curated UniProt residues grouped by drug-discovery relevance — catalytic, ligand-binding, modification, and mutation-validated positions. Source: UniProtKB sequence features.
Post-translational modifications (6): 63, 88, 155, 172, 200, 214
Function
Pathways and Gene Ontology
Reactome pathways
0 pathways
MSigDB gene sets: 98 (showing top):
GSE45365_NK_CELL_VS_CD8A_DC_MCMV_INFECTION_UP, GOBP_NEGATIVE_REGULATION_OF_CELL_GROWTH, GOZGIT_ESR1_TARGETS_DN, GOBP_GROWTH, GOBP_REGULATION_OF_CELL_CYCLE, JAATINEN_HEMATOPOIETIC_STEM_CELL_UP, GOBP_METHYLATION, GOBP_CELL_FATE_COMMITMENT, GOBP_CELL_GROWTH, GOBP_REGULATION_OF_GROWTH, GOMF_CHROMATIN_BINDING, GOMF_TRANSFERASE_ACTIVITY_TRANSFERRING_ONE_CARBON_GROUPS, GOMF_SEQUENCE_SPECIFIC_DNA_BINDING, RODRIGUES_THYROID_CARCINOMA_ANAPLASTIC_DN, GOBP_FIBROBLAST_APOPTOTIC_PROCESS
GO Biological Process (9): regulation of transcription by RNA polymerase II (GO:0006357), negative regulation of cell growth (GO:0030308), methylation (GO:0032259), regulation of MAPK cascade (GO:0043408), cell fate commitment (GO:0045165), negative regulation of DNA-templated transcription (GO:0045892), positive regulation of DNA-templated transcription (GO:0045893), regulation of cell cycle (GO:0051726), positive regulation of fibroblast apoptotic process (GO:2000271)
GO Molecular Function (6): RNA polymerase II cis-regulatory region sequence-specific DNA binding (GO:0000978), chromatin binding (GO:0003682), DNA-binding transcription factor activity (GO:0003700), methyltransferase activity (GO:0008168), protein binding (GO:0005515), transferase activity (GO:0016740)
GO Cellular Component (3): nucleus (GO:0005634), cytoplasm (GO:0005737), cytosol (GO:0005829)
GO top-level categories
Rollup of top GO terms by namespace:
| Category | Terms |
|---|---|
| regulation of DNA-templated transcription | 4 |
| DNA-templated transcription | 2 |
| binding | 2 |
| cellular anatomical structure | 2 |
| transcription by RNA polymerase II | 1 |
| regulation of cell growth | 1 |
| cell growth | 1 |
| negative regulation of growth | 1 |
| negative regulation of cellular process | 1 |
| metabolic process | 1 |
| MAPK cascade | 1 |
| regulation of intracellular signal transduction | 1 |
| cell differentiation | 1 |
| cellular developmental process | 1 |
| negative regulation of RNA biosynthetic process | 1 |
| positive regulation of RNA biosynthetic process | 1 |
| cell cycle | 1 |
| regulation of cellular process | 1 |
| positive regulation of apoptotic process | 1 |
| fibroblast apoptotic process | 1 |
| regulation of fibroblast apoptotic process | 1 |
| RNA polymerase II transcription regulatory region sequence-specific DNA binding | 1 |
| cis-regulatory region sequence-specific DNA binding | 1 |
| transcription cis-regulatory region binding | 1 |
| transcription regulator activity | 1 |
| transferase activity, transferring one-carbon groups | 1 |
| catalytic activity | 1 |
| intracellular membrane-bounded organelle | 1 |
| intracellular anatomical structure | 1 |
| cytoplasm | 1 |
Protein interactions and networks
STRING
524 interactions, top by confidence (×1000):
| Protein A | Protein B | Partner UniProt | Score |
|---|---|---|---|
| PRDM11 | PRDM16 | Q9HAZ2 | 597 |
| PRDM11 | PRDM12 | Q9H4Q4 | 542 |
| PRDM11 | PRDM5 | Q9NQX1 | 538 |
| PRDM11 | MBIP | Q9NS73 | 514 |
| PRDM11 | CAPNS2 | Q96L46 | 507 |
| PRDM11 | ITPK1 | Q13572 | 505 |
| PRDM11 | PRDM8 | Q9NQV8 | 495 |
| PRDM11 | ASH1L | Q9NR48 | 487 |
| PRDM11 | PRDM13 | Q9H4Q3 | 482 |
| PRDM11 | PDE8B | O95263 | 479 |
| PRDM11 | MECOM | Q03112 | 465 |
| PRDM11 | SETD4 | Q9NVD3 | 450 |
| PRDM11 | C11orf71 | Q6IPW1 | 446 |
| PRDM11 | B4GALT6 | Q9UBX8 | 442 |
| PRDM11 | PDE10A | Q9Y233 | 431 |
IntAct
8 interactions, top by confidence:
| A | B | Type | Score |
|---|---|---|---|
| FHL2 | PRDM11 | psi-mi:“MI:0915”(physical association) | 0.560 |
| KXD1 | HIP1 | psi-mi:“MI:0914”(association) | 0.530 |
| KXD1 | TRAK2 | psi-mi:“MI:0914”(association) | 0.530 |
| PRDM11 | ERCC3 | psi-mi:“MI:0914”(association) | 0.350 |
| PRDM11 | LONRF3 | psi-mi:“MI:0914”(association) | 0.350 |
| FHL2 | PRDM11 | psi-mi:“MI:0915”(physical association) | 0.000 |
BioGRID (21): PRDM11 (Affinity Capture-RNA), PRDM11 (Affinity Capture-MS), FHL2 (Two-hybrid), PRDM11 (Affinity Capture-MS), PRDM11 (Affinity Capture-MS), GTF2H2C (Affinity Capture-MS), PRDM11 (Affinity Capture-MS), GTF2F1 (Affinity Capture-MS), GTF2H1 (Affinity Capture-MS), GTF2H4 (Affinity Capture-MS), PRDM11 (Affinity Capture-MS), PRDM11 (Affinity Capture-MS), ACP1 (Affinity Capture-MS), RPS27 (Affinity Capture-MS), PRDM11 (Affinity Capture-MS)
ESM2 similar proteins: A0A5K7RLP0, A1YEX3, A2AGX3, A2AKB4, A7YWH3, A8MVX0, C9JSJ3, O08715, O88286, O88884, P24278, P97303, P97432, Q17RG1, Q1XFL1, Q3KNY0, Q3USH1, Q495C1, Q4V7B1, Q501R9, Q562E2, Q5SYB0, Q5VT97, Q5XIN1, Q6P2K3, Q6PCP7, Q6ZSG2, Q7TSX9, Q80SU3, Q80TL0, Q80W88, Q80XI1, Q8BLK9, Q8BSV3, Q8BW86, Q8K3E9, Q8K451, Q8N7W2, Q8NE31, Q8NFN8
Diamond homologs: A0A163UT06, A2A935, A2AGX3, A2AJ77, B8A5Y1, E9Q3T6, O75626, P0C6Y7, P14404, Q03112, Q13029, Q3UZD5, Q60636, Q63755, Q6P2A1, Q8BZ97, Q96EQ9, Q9GZV8, Q9H4Q4, Q9HAZ2, Q9NQV5, Q9NQV7, Q9NQV8, Q9NQW5, A6QPM3, E9Q8T2, P57071, Q5R5M1, Q80V63, Q9NQX0, Q9QZP2, Q9UKN5, E9PZZ1, Q9CXE0, Q9H4Q3, Q5HZG9, Q96MN9, A2BID7, Q6DCW1, Q9VH70
SIGNOR signaling
0 interactions.
Disease & clinical
Clinical variants and AI predictions
ClinVar
11 variants total. Per-class counts are floors (≥ shown; pagination cap):
| Classification | Count (floor) |
|---|---|
| Pathogenic | 0 |
| Likely pathogenic | 0 |
| Uncertain significance | 0 |
| Likely benign | 0 |
| Benign | 0 |
Top pathogenic / likely-pathogenic (0)
SpliceAI
2101 predictions. Top by Δscore:
| Variant | Effect | Δscore |
|---|---|---|
| 11:45181721:T:A | acceptor_gain | 1.0000 |
| 11:45181733:T:A | acceptor_gain | 1.0000 |
| 11:45181735:T:TA | acceptor_gain | 1.0000 |
| 11:45181738:T:TA | acceptor_gain | 1.0000 |
| 11:45181745:A:AG | acceptor_gain | 1.0000 |
| 11:45181753:C:CA | acceptor_gain | 1.0000 |
| 11:45181760:GGACA:G | acceptor_gain | 1.0000 |
| 11:45181868:GGA:G | donor_gain | 1.0000 |
| 11:45181869:GAG:G | donor_gain | 1.0000 |
| 11:45181871:G:GG | donor_gain | 1.0000 |
| 11:45182224:T:TA | acceptor_gain | 1.0000 |
| 11:45182226:C:CA | acceptor_gain | 1.0000 |
| 11:45182227:G:A | acceptor_gain | 1.0000 |
| 11:45182234:T:A | acceptor_gain | 1.0000 |
| 11:45182239:T:TA | acceptor_gain | 1.0000 |
| 11:45182345:CTGGT:C | donor_gain | 1.0000 |
| 11:45182346:TGGT:T | donor_gain | 1.0000 |
| 11:45182347:GGTG:G | donor_gain | 1.0000 |
| 11:45182348:GT:G | donor_gain | 1.0000 |
| 11:45182349:TG:T | donor_loss | 1.0000 |
| 11:45182350:G:GG | donor_gain | 1.0000 |
| 11:45182851:A:AG | acceptor_gain | 1.0000 |
| 11:45182852:T:G | acceptor_gain | 1.0000 |
| 11:45182857:CCA:C | acceptor_loss | 1.0000 |
| 11:45182858:CAGT:C | acceptor_loss | 1.0000 |
| 11:45182859:A:AG | acceptor_gain | 1.0000 |
| 11:45182859:A:T | acceptor_loss | 1.0000 |
| 11:45182859:AGTCT:A | acceptor_gain | 1.0000 |
| 11:45182860:G:A | acceptor_loss | 1.0000 |
| 11:45182860:G:GA | acceptor_gain | 1.0000 |
AlphaMissense
0 scored. Top likely-pathogenic:
dbSNP variants (sampled 300 via entrez): RS1000004841 (11:45145279 G>A), RS1000044787 (11:45162821 T>A,C), RS1000045409 (11:45166677 G>A,T), RS1000075852 (11:45162618 G>C), RS1000123919 (11:45092817 A>G), RS1000140118 (11:45205591 C>A,T), RS1000145306 (11:45115066 C>T), RS1000161022 (11:45209527 C>G), RS1000175605 (11:45126446 A>G), RS1000225598 (11:45203902 A>G), RS1000250581 (11:45159433 GT>G), RS1000265121 (11:45199358 C>T), RS1000278298 (11:45209723 C>T), RS1000279041 (11:45168854 G>A,T), RS1000283783 (11:45165970 C>G)
Disease associations
OMIM: gene MIM:616347 | disease phenotypes:
GenCC curated gene-disease
Mondo (0):
Orphanet (0):
HPO phenotypes
0 total (0 of 0 shown, HPO-id order):
GWAS associations
26 associations (top):
| Study | Trait | p-value |
|---|---|---|
| GCST001856_29 | Thyroid hormone levels | 3.000000e-07 |
| GCST001856_9 | Thyroid hormone levels | 9.000000e-11 |
| GCST002483_4 | Lung function (forced vital capacity) | 9.000000e-10 |
| GCST004278_29 | Pulse pressure | 7.000000e-09 |
| GCST006138_2 | Resting-state electroencephalogram vigilance | 8.000000e-06 |
| GCST006193_3 | Diastolic blood pressure x smoking status (current vs non-current) interaction (2df test) | 1.000000e-09 |
| GCST006194_6 | Diastolic blood pressure x smoking status (current vs non-current) interaction (1df test) | 1.000000e-08 |
| GCST006268_464 | Reaction time | 9.000000e-10 |
| GCST006268_521 | Reaction time | 2.000000e-09 |
| GCST006268_522 | Reaction time | 1.000000e-09 |
| GCST006268_523 | Reaction time | 1.000000e-09 |
| GCST006268_524 | Reaction time | 1.000000e-09 |
| GCST006897_4 | Hyperthyroidism | 3.000000e-11 |
| GCST006956_5 | Erectile dysfunction | 9.000000e-06 |
| GCST007096_190 | Pulse pressure | 5.000000e-12 |
| GCST007097_13 | Pulse pressure | 2.000000e-06 |
| GCST007429_144 | Lung function (FVC) | 7.000000e-09 |
| GCST007432_141 | FEV1 | 1.000000e-10 |
| GCST010043_48 | Asthma | 1.000000e-11 |
| GCST010653_46 | Thyroid stimulating hormone levels | 3.000000e-41 |
| GCST012047_6 | Fasting glucose | 7.000000e-07 |
| GCST012100_8 | Hypertrophic cardiomyopathy (sarcomere positive) | 2.000000e-06 |
| GCST90020025_935 | Waist-to-hip ratio adjusted for BMI | 4.000000e-08 |
| GCST90020026_790 | Hip index | 2.000000e-08 |
| GCST90020026_791 | Hip index | 4.000000e-12 |
| GCST90020027_1460 | Waist-hip index | 2.000000e-08 |
EFO canonical traits (10, from GWAS)
| EFO ID | Trait name |
|---|---|
| EFO:0004730 | hormone measurement |
| EFO:0004312 | vital capacity |
| EFO:0005763 | pulse pressure measurement |
| EFO:0004357 | electroencephalogram measurement |
| EFO:0006336 | diastolic blood pressure |
| EFO:0006527 | smoking status measurement |
| EFO:0008393 | reaction time measurement |
| EFO:0004314 | forced expiratory volume |
| EFO:0007788 | BMI-adjusted waist-hip ratio |
| EFO:0008039 | BMI-adjusted hip circumference |
Drugs & pharmacology
Drug and pharmacology data
Is drug target: yes
ChEMBL targets (1): CHEMBL5214857 (SINGLE PROTEIN)
PharmGKB: 1 entry (VIP=true, CPIC=false)
CTD chemical–gene interactions
25 total (human), top 25 by PubMed support.
| Chemical | Actions (top 5) | PubMed papers |
|---|---|---|
| Benzo(a)pyrene | affects methylation, increases expression, increases methylation | 3 |
| Valproic Acid | decreases expression, increases methylation | 3 |
| bisphenol A | decreases methylation, affects cotreatment, increases expression | 2 |
| bisphenol F | affects cotreatment, increases expression | 1 |
| TAK-243 | decreases sumoylation | 1 |
| dicrotophos | increases expression | 1 |
| methylmercuric chloride | decreases expression | 1 |
| triphenyl phosphate | affects expression | 1 |
| benzo(e)pyrene | increases methylation | 1 |
| ferrous chloride | decreases expression | 1 |
| aflatoxin B2 | increases methylation, decreases methylation | 1 |
| cylindrospermopsin | increases expression | 1 |
| CGP 52608 | affects binding, increases reaction | 1 |
| abrine | increases expression | 1 |
| Cisplatin | decreases expression | 1 |
| Dexamethasone | affects cotreatment, increases expression | 1 |
| Doxorubicin | decreases expression | 1 |
| Indomethacin | affects cotreatment, increases expression | 1 |
| Lead | affects expression | 1 |
| Methapyrilene | increases methylation | 1 |
| Smoke | decreases expression | 1 |
| Tretinoin | decreases expression | 1 |
| Urethane | decreases expression | 1 |
| 1-Methyl-3-isobutylxanthine | affects cotreatment, increases expression | 1 |
| Palmitic Acid | increases expression | 1 |
ChEMBL screening assays
1 unique, capped per target: 1 binding
Representative assays (with source publication via chembl_document):
| Assay ID | Type | Description | Source paper |
|---|---|---|---|
| CHEMBL5214660 | Binding | Selectivity interaction (Methyltransferase panel (DSF assay)) EUB0000234b PRDM11 | Selectivity Literature for EUbOPEN Chemogenomics Library wave 3 |
Clinical trials (associated diseases)
0 trials via MONDO — disease-level, not drug-specific.
Related Atlas pages
- Disease cohort memberships (association, not causation — diseases whose associated-gene cohort lists this gene; a subset are also under Associated diseases): erectile dysfunction, hyperthyroidism, hypertrophic cardiomyopathy