In contrast, HOX Transcript Antisense Intergenic RNA (HOTAIR) alleviates oxidative stress and myocardial death of DCM via sponging miR-34a and activating the SIRT1/FOXO1 pathway (57), is specifically downregulated in DCM patients and serves as a promising biomarker for DCM (58). Here, FOXO1 is linked to familial dilated cardiomyopathy.