Dilated cardiomyopathy: second hits knock-down the heart

Figure 1 The clinical presentation and outcome of DCM or NDLVC are determined by the common co-existence of both genetic -mono and polygenic risk-and acquired factors (such as toxins, viruses, and auto-immune diseases), disease modifiers (such as pregnancy), or co-morbidities (diabetes, hypertension, endocrinopathies, and renal, hepatic or (micro)-vascular disease).