BackgroundHypertrophic cardiomyopathy (HCM) is a heterogeneously inherited cardiac disorder with unclear biological pathogenesis. This study aims to identify the key modules and genes involved in the development of HCM.MethodsUsing weighted gene co-expression network analysis (WGCNA) algorithm, we constructed integrative co-expression networks for the two large sample HCM datasets separately. After selecting clinically significant modules with the same clinical trait, functional enrichment analysis was performed to detect their common pathways. Based on the intramodular connectivity (IC), the shared hub genes were generated, validated, and further explored in gene set enrichment analysis (GSEA).ResultsThe orange and pink modules in GSE141910, the green and brown modules in GSE36961 were mostly related to HCM. Functional enrichment analysis suggested that HCM might exhibit enhanced processes including remodeling of extracellular matrix, activation of abnormal protein signaling, aggregation of calcium ion, and organization of cytoskeleton. SMOC2, COL16A1, RASL11B, TUBA3D, IL18R1 were defined as real hub genes due to their top IC values, significantly different expression levels, and excellent diagnostic performance in both datasets. Moreover, GSEA analysis demonstrated that pathways of the five hub genes were mainly involved in neuroactive ligand-receptor interaction, ECM-receptor interaction, Hedgehog signaling pathway.ConclusionOur study provides more comprehensive insights into the molecular mechanisms of HCM, identifies five hub genes as candidate biomarkers for HCM, which might be theoretically feasible for targeted therapy against HCM.