Position paperManagement of nonischemic-dilated cardiomyopathies in clinical practice: a position paper of the working group on myocardial and pericardial diseases of Italian Society of CardiologyMerlo, Marcoa; Masè, Marcoa; Cannatà, Antonioa; Zaffalon, Denisea; Lardieri, Gerardinab; Limongelli, Giuseppec; Imazio, Massimod; Canepa, Marcoe,f; Castelletti, Silviag; Bauce, Barbarah; Biagini, Elenai; Livi, Ugolinoj; Severini, Giovanni M.k; Dal Ferro, Matteoa; Marra, Martina Perazzoloh; Basso, Cristinah; Autore, Camillol; Sinagra, GianfrancoaAuthor Information aCardiothoracovascular Department , Center for Diagnosis and Management of Cardiomyopathies, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste bCardiology Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Hospital of Gorizia and Monfalcone cDepartment of Translational Medical Sciences, Inherited and Rare Heart Disease, Vanvitelli Cardiology, University of Campania Luigi Vanvitelli, Caserta dUniversity Cardiology, A.O.U. Città della Salute e della Scienza di Torino, Torino eCardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino – IRCCS Italian Cardiovascular Network fDepartment of Internal Medicine, University of Genova, Genova gIRCCS Istituto Auxologico Italiano, Center for Cardiac Arrhythmias of Genetic Origin, Milan hDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padova iAzienda Ospedaliero - Universitaria, Policlinico di Sant’Orsola, Cardiology Unit, Cardio-Thoracic-Vascular Department, Bologna, Italy jCardiothoracic Department, University Hospital of Udine, Udine kInstitute for Maternal and Child Health-IRCCS ‘Burlo Garofolo’, Trieste lDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy Correspondence to Gianfranco Sinagra, MD, FESC, Cardiothoracovascular Department, Center for Diagnosis and Management of Cardiomyopathies, Azienda Sanitaria Universitaria Integrata (ASUITS), University of Trieste, Via P. Valdoni, 7, 34100 Trieste, Italy Tel: +39 040 3994477; fax: +39 040 3994878; e-mail: [email protected] Received 8 December, 2019 Revised 2 March, 2020 Accepted 4 April, 2020 Journal of Cardiovascular Medicine: December 2020 - Volume 21 - Issue 12 - p 927-943 doi: 10.2459/JCM.0000000000001050 Buy Metrics Abstract Nonischemic-dilated cardiomyopathy (NIDCM) is an entity that gathers extremely heterogeneous diseases. This awareness, although leading to continuous improvement in survival, has increased the complexity of NIDCM patients’ management. Even though the endorsed ‘red-flags’ approach helps clinicians in pursuing an accurate etiological definition in clinical practice, it is not clear when and how peripheral centers should interact with referral centers with specific expertise in challenging scenarios (e.g. postmyocarditis and genetically determined dilated cardiomyopathy) and with easier access to second-line diagnostic tools and therapies. This position paper will summarize each step in NIDCM management, highlighting the multiple interactions between peripheral and referral centers, from first-line diagnostic workup and therapy to advanced heart failure management and long-term follow-up. © 2020 Italian Federation of Cardiology - I.F.C. All rights reserved.