Article Sections

Introduction

Dilated cardiomyopathy (DCM) occurs due to a direct insult to cardiomyocytes that leads to a decrease in contractile function of one or both ventricles, with a consequent increase in ventricular cavity size.  It can result from a variety of causes, including infection, chemical toxicity, and other disturbances; inherited familial patterns may frequently contribute to the disease.  DCM is one of the major causes of heart failure with reduced ejection fraction (HFrEF) and is considered a separate entity from other major causes of ventricular dilation and HFrEF, including ischemic heart disease and valvular heart disease.

Pathophysiology

After being subjected to a direct insult (eg, viral infection, toxins), cardiomyocytes can begin to lose contractile function, and a reduction in stroke volume causes left ventricular (LV) volume overload.  In response to LV volume overload, LV stretch increases stroke volume via the Frank-Starling mechanism.  In addition, compensatory eccentric hypertrophy develops to allow a further increase in stroke volume but at the expense of increased LV wall stress (

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