IGF1 and familial dilated cardiomyopathy: The pathophysiological mechanisms underlying DCM include excessive reactive oxygen species (ROS) production, apoptosis, overactivity of myocardial renin angiotensin system (RAS) and insulin-like growth factor-1 (IGF-1) as well as transforming growth factor beta 1 (TGF-β1), collagen deposition and fibrosis [7,8].