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Published online by Cambridge University Press: 20 November 2023 Abstract Impact statement Introduction The genetic architecture of DCM Precision therapy in gene elusive disease Cardiac imaging Blood biomarkers Precision phenotyping in DCM Co-morbidities and lifestyle Conclusion Open peer review Data availability statement Author contribution Financial support Competing interest References Abstract Precision medicine for cardiomyopathies holds great promise to improve patient outcomes costs by shifting the focus to patient-specific treatment decisions, maximising the use of therapies most likely to lead to benefit and minimising unnecessary intervention