Furthermore, RNA sequencing and functional analysis showed that Decr1 interacted with and upregulated pyruvate dehydrogenase kinase 4 (PDK4) in injured cardiomyocytes, and overexpression of PDK4 eliminated the benefits of Decr1 downregulation in DCM (−20% for EF, p = 0.0071; −28% for FS, p = 0.0022). This evidence concerns the gene DECR1 and familial dilated cardiomyopathy.