The pharmacological treatment of dilated cardiomyopathy overlaps with the treatment of heart failure. The primary objective
of this treatment is to slow the progression of disease and improve quality and length of life. All patients, including those with asymptomatic
dysfunction of the left ventricle, ought to receive angiotensin converting enzyme inhibitors, (in the case of intolerance, angiotensin
receptor blockers), and beta blockers. The results of studies involving aliskiren have been, so far, disappointing. In symptomatic heart
failure NYHA II-IV diuretics and mineralcorticoid receptor antagonists should be added to treatment. Digoxin is recommended in the
event of atrial fibrillation, and otherwise only in the event of NYHA III and IV. Ivabradine is recommended for patients with sinus
rhythm and pulse rate of > 70/min.
In decompensation of heart failure, dobutamine, phosphodiesterase inhibitors or levosimendan are administered over the short-term. Of
the recent treatment options, the vasopressin blocker and adenosine A1 receptor antagonist (rolofylline) were disappointing. One treatment
with potential for the future is omecamtiv mecarbil, a heart myosin activator.