Defining the genetics, biomarkers and outcomes for dilated cardiomyopathy: a prospective multi-centre study (GO-DCM)

Two thousand people with dilated cardiomyopathy will undergo heart scans, genetic sequencing, and blood tests to uncover why the heart muscle weakens and why outcomes vary so widely. Dilated cardiomyopathy is a leading cause of heart failure and sudden death, yet in most patients the underlying cause remains unknown. Current treatments are blunt—they manage symptoms rather than target the disease’s root. This study combines three tools—cardiac MRI, whole genome sequencing, and blood-based biomarkers—to map the disease in unprecedented detail. A particular focus is cardiac fibrosis, the scarring that stiffens the heart, which will be tracked through imaging and circulating markers. High-field spectroscopy will also probe how specific genetic variants alter heart metabolism. If successful, this research could transform how dilated cardiomyopathy is diagnosed and managed. Instead of a one-size-fits-all approach, doctors might stratify patients by genetic risk and fibrosis burden, enabling earlier, more personalised interventions. The findings could also identify new drug targets, particularly for fibrosis, which currently has no approved therapy. This is the largest prospective study of its kind, and its results will reshape clinical guidelines for a condition that quietly disables thousands of people each year.