For cases (Heart Failure on the basis of DCM) Inclusion Criteria: * Signed and dated the Informed Consent Form * Male and female subjects ≥18 years of age * Chronic Heart failure (HF) with LVEF ≤40% * HF due to dilated cardiomyopathy (DCM) * New York Heart Association (NYHA) class ≥2 * Treatment with basic optimal medical therapy. * Clinical indication for invasive evaluation of heart failure Exclusion Criteria: * Life expectancy \< 3 years due to other reasons than cardiovascular, cardiac transplantation or left ventricular assist device * Diabetes mellitus type 1 and 2 * Known hereditary hypercholesterolemia * Ongoing lipid lowering therapy * Patients on ketogenic diets * BMI\>35 or \<19 * Pregnancy * Any current life-threatening cardiac dysrhythmia, cardiac surgery, acute coronary syndrome, or non-elective percutaneous coronary intervention (PCI) \<3 months * Current significant major or unstable respiratory disease * Considerable hematological disease, hepatic disease, renal disease and/or gastrointestinal disease * Stroke, transient ischemic attack, carotid surgery or angioplasty \<3months * estimated glomerular filtration rate (eGFR) by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI formula) \<30 mL/min/1.73m2 or patients on renal dialysis * Expected inability (by the investigator) to comply with the protocol * Subjects incapable to giving consent personally For control subjects (no heart failure) Inclusion criteria: * Signed and dated Informed Consent Form * Male and female subjects ≥18 years of age * Clinical indication for electrophysiology examination Exclusion criteria: * Heart Failure (HFpEF, heart failure with mid-range ejection fraction (HFmrEF) or HFrEF) * Life expectancy \< 3 years due to other reasons than cardiovascular, cardiac transplantation or left ventricular assist device * Diabetes mellitus type 1 and 2 * Known hereditary hypercholesterolemia * Ongoing lipid lowering therapy * Patients on ketogenic diets * BMI\>35 or \<19 * Pregnancy * Any current life-threatening cardiac dysrhythmia, cardiac surgery, acute coronary syndrome, or non-elective PCI \<3 months * Current significant major or unstable respiratory disease * Considerable hematological disease, hepatic disease, renal disease and/or gastrointestinal disease * Stroke, transient ischemic attack, carotid surgery or angioplasty \<3months, * eGFR by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI formula) \<30 mL/min/1.73m2 or patients on renal dialysis * Expected inability (by the investigator) to comply with the protocol * Subjects incapable to giving consent personally

Metabolic Characterization of Patients With Dilated Cardiomyopathy

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Where and how to apply