Activation of TLR4, caspase-1, IL-1β, and mast cells are also known to increase myocarditis and promote remodeling, fibrosis, and DCM in CVB3 myocarditis in male mice (44, 54) suggesting that BPA exposure could increase the risk of progression from myocarditis to DCM and heart failure in women. This evidence concerns the gene TLR4 and familial dilated cardiomyopathy.