Pathogenesis and treatment of cardiomyopathy.

Dilated cardiomyopathy is a disease of diverse causes. Untreated, this condition will likely progress to advanced heart failure, sudden death, or both. There have been a number of significant advances in the understanding of the mechanisms involved in the pathogenesis of this disease. Treatments that counteract ventricular remodeling with neurohumoral blockade have substantially improved the outcome for many patients. Although cardiac transplantation is of benefit to patients with advanced disease, the growing donor heart shortage limits this option. New treatments are clearly needed, and many are being actively investigated. As the genetic and cellular derangements that result in dilated cardiomyopathy are better understood, new therapeutic targets will be identified in the quest to restore normal cardiac structure and function.