Figure 3.

Lipotoxicity as a main pathogenic mechanism of DCM. Increased uptake of fatty acids by cardiomyocytes favors their accumulation as triglycerides within the cells. Moreover, inefficient oxidation of fatty acids by dysfunctional mitochondria leads to excessive production of ROS and cell death. Lipid intermediates and other lipid species, such as ceramides and diacylglycerols, also accumulate in cardiomyocytes and activate PKCs, promoting fibrosis and cell death.