Fig. 1

An overview of heart failure syndromes showing where dilated cardiomyopathy (DCM) and systolic heart failure fit in relation to all heart failure syndromes. Heart failure syndromes encompass clinical symptoms and/or signs of heart failure and evidence of myocardial dysfunction. This can occur in the setting of reduced (HFrEF; left ventricular ejection fraction <40%) or preserved (HFpEF; left ventricular ejection fraction >50%) left ventricular ejection fraction. The contribution of HFpEF, previously referred to as diastolic heart failure, to heart failure syndromes ranges from 22 to 73%, reflecting the difficulties in defining the condition and the diversity of the populations studied [8]. Recently, a third category of heart failure with mid-range ejection fraction (HFmrEF; left ventricular ejection fraction 40–49%) has been identified [8], although it has not yet been encompassed into clinical studies. The commonest cause of HFrEF is myocardial ischemia. DCM can be a subset of HFrEF and is the commonest cardiomyopathy (CM) to cause heart failure syndromes. Although DCM can present with the clinical syndrome of systolic heart failure, it can also present with arrhythmias or thrombo-embolic disease or be detected in the asymptomatic patient. DCM therefore does not equate with systolic heart failure. DCM is predominantly an imaging diagnosis, whereas heart failure is a clinical and imaging diagnosis. DCM dilated cardiomyopathy; Other CMs other cardiomyopathies, including hypertrophic cardiomyopathy