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uanosine monophosphate (c-di-GMP).BACKGROUND TBX5 is a transcription factor that has an important role in development of heart. TBX5 variants in the region encoding the T-box domain have been shown to cause cardiac defects, such as atrial septal defect or ventricular septal defect, while TBX5 variants have also been identified in a few cardiomyopathy patients and considered causative. We identified a TBX5 variant (c.791GA, p.Arg264Lys), that is over-represented in cardiomyopathy patients. This variant is located outside of the T-box