{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T11:04:06Z","timestamp":1789643046117,"version":"4.0.0"},"reference-count":58,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Non-dilated left ventricular cardiomyopathy has recently emerged as a distinct morpho-functional phenotype defined by non-ischemic left ventricular scarring or fatty replacement or by isolated global left ventricular hypokinesia without scarring in the absence of ventricular dilatation. Whether it represents a distinct biological entity or a shared phenotypic expression across cardiomyopathies remains unresolved. This narrative review examines evidence from genetics, multimodality imaging, natural history, and outcomes. Overlap with dilated and arrhythmogenic cardiomyopathies is extensive: no currently validated genetic, imaging, histological, or circulating marker uniquely identifies the phenotype, and longitudinal studies describe heterogeneous trajectories from reverse remodeling to dilated or predominantly arrhythmogenic evolution. Genetics argues in both directions, as the genes involved are shared yet their distribution differs, pro-arrhythmogenic variants being more frequent than in dilated cardiomyopathy. We propose a hypothesis-generating framework of three probable trajectories, evolving dilated cardiomyopathy, evolving arrhythmogenic cardiomyopathy, or stable non-dilated disease, integrating genotype, multiparametric cardiac magnetic resonance, longitudinal remodeling, and arrhythmic phenotype.<\/jats:p>","DOI":"10.3390\/jcm15187214","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T09:59:03Z","timestamp":1789639143000},"page":"7214","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Non-Dilated Left Ventricular Cardiomyopathy: Exploring the Spectrum from Phenotype to Disease Entity"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3767-7595","authenticated-orcid":false,"given":"Francesco","family":"Mangini","sequence":"first","affiliation":[{"name":"Cardiology Department, Ecclesiastical Entity Regional General Hospital \u201cF. Miulli\u201d, 70021 Acquaviva delle Fonti, BA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9347-8884","authenticated-orcid":false,"given":"Massimo","family":"Grimaldi","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ecclesiastical Entity Regional General Hospital \u201cF. Miulli\u201d, 70021 Acquaviva delle Fonti, BA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1297-2056","authenticated-orcid":false,"given":"Antonio","family":"Di Monaco","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ecclesiastical Entity Regional General Hospital \u201cF. Miulli\u201d, 70021 Acquaviva delle Fonti, BA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2500-8335","authenticated-orcid":false,"given":"Fabrizio","family":"Fortunato","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ecclesiastical Entity Regional General Hospital \u201cF. Miulli\u201d, 70021 Acquaviva delle Fonti, BA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Vitulano","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ecclesiastical Entity Regional General Hospital \u201cF. Miulli\u201d, 70021 Acquaviva delle Fonti, BA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4485-326X","authenticated-orcid":false,"given":"Federico","family":"Quadrini","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ecclesiastical Entity Regional General Hospital \u201cF. Miulli\u201d, 70021 Acquaviva delle Fonti, BA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3177-2749","authenticated-orcid":false,"given":"Ilaria","family":"Dentamaro","sequence":"additional","affiliation":[{"name":"Cardiology Department, Policlinico di Bari University Hospital, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1718-9949","authenticated-orcid":false,"given":"Marco","family":"Guglielmo","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Spinelli","sequence":"additional","affiliation":[{"name":"Radiology Department, Ecclesiastical Entity Regional General Hospital \u201cF. Miulli\u201d, 70021 Acquaviva delle Fonti, BA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Grimaldi","sequence":"additional","affiliation":[{"name":"Radiology Department, Ecclesiastical Entity Regional General Hospital \u201cF. Miulli\u201d, 70021 Acquaviva delle Fonti, BA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2116-3293","authenticated-orcid":false,"given":"Francesca","family":"Musella","sequence":"additional","affiliation":[{"name":"Cardiology Department, Santa Maria delle Grazie Hospital, 80078 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8475-8270","authenticated-orcid":false,"given":"Luca","family":"Sgarra","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ecclesiastical Entity Regional General Hospital \u201cF. Miulli\u201d, 70021 Acquaviva delle Fonti, BA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2097-2032","authenticated-orcid":false,"given":"Simona","family":"Quarta","sequence":"additional","affiliation":[{"name":"Cardiology Department, Policlinico di Bari University Hospital, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0018-4669","authenticated-orcid":false,"given":"Sergio","family":"Suma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Parma University Hospital, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6363-9571","authenticated-orcid":false,"given":"Robert W. W.","family":"Biederman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, West Virginia University, Morgantown, WV 26506, USA"},{"name":"Department of Cardiology, Medical University of South Carolina, Charleston, SC 29425, USA"},{"name":"Department of Cardiology, Roper\/Saint Francis Hospital, Charleston, SC 29403, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0934-8890","authenticated-orcid":false,"given":"Roberto","family":"Calbi","sequence":"additional","affiliation":[{"name":"Radiology Department, Ecclesiastical Entity Regional General Hospital \u201cF. 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