Mechanisms of idiopathic dilated cardiomyopathies

PURPOSE OF REVIEW: Dilated cardiomyopathy is a disease of the heart muscle, characterized by ventricular dilation and depressed myocardial contractility in the absence of abnormal loading conditions or ischemic heart disease. Dilated cardiomyopathy may be viewed as a progressive disorder that is initiated after an 'index event' damages the heart muscle, thereby preventing the heart from contracting normally. This review will discuss the mechanisms of dilated cardiomyopathy, with special focus on familial dilated cardiomyopathy and virus-induced dilated cardiomyopathy. RECENT FINDINGS: In the past few years, discoveries in molecular genetics and virology have offered insights into the pathomechanisms of dilated cardiomyopathy. SUMMARY: The increasing knowledge of a potential causal link between genetic mutations and viral infections and the development of dilated cardiomyopathy may lead to a breakthrough in the treatment of the disease. In particular, the development of gene therapy to treat familial cardiomyopathy and the development of antiviral agents to treat persistent viral infections in virus-induced cardiomyopathy could greatly enhance the treatment of dilated cardiomyopathy.