{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:13:51Z","timestamp":1789517631612,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T00:00:00Z","timestamp":1686268800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Netherlands Cardiovascular Research Initiative","award":["CVON Arena-PRIM"],"award-info":[{"award-number":["CVON Arena-PRIM"]}]},{"name":"Netherlands Cardiovascular Research Initiative","award":["DCVA DOUBLE DOSIS"],"award-info":[{"award-number":["DCVA DOUBLE DOSIS"]}]},{"name":"Dutch Heart Foundation","award":["CVON Arena-PRIM"],"award-info":[{"award-number":["CVON Arena-PRIM"]}]},{"name":"Dutch Heart Foundation","award":["DCVA DOUBLE DOSIS"],"award-info":[{"award-number":["DCVA DOUBLE DOSIS"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Dilated cardiomyopathy (DCM) has a genetic cause in up to 40% of cases, with differences in disease penetrance and clinical presentation, due to different exogeneous triggers and implicated genes. Cardiac inflammation can be the consequence of an exogeneous trigger, subsequently unveiling a phenotype. The study aimed to determine cardiac inflammation in a cohort of genetic DCM patients and investigate whether it associated with a younger disease onset. The study included 113 DCM patients with a genetic etiology, of which 17 had cardiac inflammation as diagnosed in an endomyocardial biopsy. They had a significant increased cardiac infiltration of white blood, cytotoxic T, and T-helper cells (p &lt; 0.05). Disease expression was at a younger age in those patients with cardiac inflammation, compared to those without inflammation (p = 0.015; 50 years (interquartile range (IQR) 42\u201353) versus 53 years (IQR 46\u201361). However, cardiac inflammation was not associated with a higher incidence of all-cause mortality, heart failure hospitalization, or life-threatening arrhythmias (hazard ratio 0.85 [0.35\u20132.07], p = 0.74). Cardiac inflammation is associated with an earlier disease onset in patients with genetic DCM. This might indicate that myocarditis is an exogeneous trigger unveiling a phenotype at a younger age in patients with a genetic susceptibility, or that cardiac inflammation resembles a \u2018hot-phase\u2019 of early-onset disease.<\/jats:p>","DOI":"10.3390\/jcm12123937","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T02:03:18Z","timestamp":1686276198000},"page":"3937","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Cardiac Inflammation in Adult-Onset Genetic Dilated Cardiomyopathy"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8165-6631","authenticated-orcid":false,"given":"Maurits A.","family":"Sikking","sequence":"first","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie L. V. M.","family":"Stroeks","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel T. H. M.","family":"Henkens","sequence":"additional","affiliation":[{"name":"Department of Pathology, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"},{"name":"Netherlands Heart Institute (NLHI), 3511 EP Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2574-6672","authenticated-orcid":false,"given":"Max F. G. H. M.","family":"Venner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pathology, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane R. B.","family":"Heymans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands"},{"name":"Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark R.","family":"Hazebroek","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5549-1298","authenticated-orcid":false,"given":"Job A. J.","family":"Verdonschot","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands"},{"name":"Department of Clinical Genetics, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1002\/ejhf.1103","article-title":"Evolving concepts in dilated cardiomyopathy","volume":"20","author":"Merlo","year":"2018","journal-title":"Eur. J. 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