DSP and Arrhythmogenic right ventricular dysplasia: Similarly, DSP (desmoplakin) mutations, typically associated with arrhythmogenic right ventricular cardiomyopathy (ARVC), may present with left-dominant arrhythmogenic DCM, often showing extensive subepicardial fibrosis, frequent premature ventricular contractions, and frequent progression to HF with preserved or mildly reduced LVEF [139].