These studies, coupled with the genetic findings of CLEC7A/DECTIN-1, PLCG2, DUOX1, and DUOXA1 variants in DCM, highlight the role of the pulmonary epithelia in immune surveillance, initial response, and AECII/alveolar macrophage crosstalk mediated by H2O2 (Figure 7B). Here, DUOXA1 is linked to familial dilated cardiomyopathy.