In the failing heart of patients with ischemic cardiomyopathy (ICM) or dilated cardiomyopathy (DCM), TIMP1 and TIMP3 levels were reduced with no change in TIMP2 and TIMP4, except TIMP4 protein decreased in ICM myocardium (Li et al., 1998); however, myocardial levels of all four TIMPs were increased in another study (Polyakova et al., 2011). This evidence concerns the gene TIMP4 and dilated cardiomyopathy.