Causes of Dilated Cardiomyopathy

Primary and Secondary Causes

The American College of Cardiology and Circulation journal suggest that dilated cardiomyopathy results from either genetic mutations (30-50% of cases) or acquired factors, including viral myocarditis, cardiotoxins, endocrine disorders, peripartum state, tachyarrhythmias, autoimmune diseases, and nutritional deficiencies 1, 2
Genetic mutations account for 30-50% of all DCM cases, with 30-40% attributable to identifiable pathogenic variants in specific protein genes, according to the American College of Cardiology and Circulation journal 1, 2

Viral myocarditis represents a well-established pathway from acute inflammation to chronic DCM, with cell-mediated autoimmune mechanisms triggered by viral infection driving progression, as reported in Circulation 2

Alcohol is a common and reversible cause of DCM when consumption is stopped early, as stated in the Journal of the American College of Cardiology 1
Chemotherapeutic agents, particularly anthracyclines and other cancer treatments, cause direct myocyte injury, according to Circulation 2, 4

Diabetes mellitus contributes to secondary cardiomyopathy through metabolic derangements, as reported in Circulation 2, 4
Thyroid disorders, both hypo- and hyperthyroidism, affect cardiac contractility, according to the Journal of the American College of Cardiology 1
Nutritional deficiencies, including thiamine, carnitine, and selenium, cause reversible DCM when severe, as stated in the Journal of the American College of Cardiology 1

Peripartum cardiomyopathy presents during the last month of pregnancy or within 5 months postpartum, with risk factors including multiparity, advanced maternal age, obesity, and hypertension, as reported in the Journal of the American College of Cardiology 1

Tachycardia-induced cardiomyopathy results from chronic supraventricular or ventricular arrhythmias with rapid rates, causing reversible systolic dysfunction, according to Circulation 5

Systemic lupus erythematosus, dermatomyositis, rheumatoid arthritis, scleroderma, and polyarteritis nodosa all associate with DCM through immune-mediated myocardial damage, as reported in the Journal of the American College of Cardiology and Circulation 1, 2, 4

Amyloidosis, hemochromatosis, and sarcoidosis cause secondary cardiomyopathy as part of multiorgan systemic disease, according to Circulation 2, 4

Stress-induced (Tako-tsubo) cardiomyopathy presents with acute, usually reversible LV dysfunction triggered by emotional or physical stress, mediated by catecholamine excess, as reported in the Journal of the American College of Cardiology and Circulation 1, 5

Long-standing uncontrolled hypertension leads to "burned-out" dilated cardiomyopathy after initial concentric hypertrophy, with progressive chamber dilation and declining ejection fraction, as stated in the Journal of the American College of Cardiology 1