These studies demonstrated intramyocardial inflammation in DCM including increased inflammatory cells (infiltration of macrophages and leucocytes) and increased expression of inflammatory cytokines [leptin, TNF-α, TGF-β1, intercellular adhesion molecule 1 and vascular cell adhesion molecule 1 (ICAM-1 and VCAM-1), interleukin1 beta (IL-1β), interleukin 6 (IL-6), and interleukin 18 (IL-18)] (121, 122, 128–131). This evidence concerns the gene IL18 and familial dilated cardiomyopathy.