One of the first studies that evaluated the cardiac extracellular matrix remodeling by analyzing the matrix metalloproteinases in DCM patients, with a focus on their possible prognostic value, was published by Franz et al. They measured the serum levels of matrix metalloproteinase 9, tissue inhibitor of metalloproteinase 1, fetal tenascin-C and fibronectin, markers known to be involved in the reorganization of the extracellular matrix, and demonstrated that an increase of every single of these parameters is significantly related to a lower survival of DCM patients [59]. This evidence concerns the gene FN1 and familial dilated cardiomyopathy.