One study found that HLA-DR1 and HLA-DRw10 were more common in patients with DCM, suggesting a genetically determined immune response contributes to the pathogenesis of this disease.59 Other studies found tumour necrosis factor alpha (TNF-α) and C-reactive protein (CRP) elevations in idiopathic DCM.60,61 Leukocyte cytokines were also shown to be elevated, even after patients were haemodynamically stabilised.62,63 These are in contrast to other cytokines, which decrease with treatment.60,61. Here, CRP is linked to familial dilated cardiomyopathy.