The TGF-β profibrotic signal in DCM may be due to the direct action of high glucose on TGF-β secretion and activation (34, 45), due to accumulation of AGEs (46), through Ang II pathway activation (47), or as a consequence of changes in the expression of some microRNAs (48). Here, TGFB1 is linked to familial dilated cardiomyopathy.