**5. Limitations**

This retrospective analysis has been conducted in patients with DCM consecutively enrolled in a tertiary referral centre. Therefore, these results might be not genuinely representative of the entire DCM spectrum and should be applied only to patients with similar characteristics. A possible selection bias imposed by the long enrolment period has been imposed by the relatively low event rate. However, guideline-directed medical treatment has been provided to all patients regardless of the date of enrolment, partially overcoming this limitation. Data on cardiac magnetic resonance, biomarkers and genetics were not available for all patients. Similarly, evaluation of the potential sex-specific effect of device therapy requires larger multicentre analysis. Therefore, limiting the investigation of these specific subgroups might introduce a significant bias in the population analysed. Lastly, sex-specific analyses on the occurrence of arrhythmic events are needed to provide more in-depth characterization of these patients. Further research is needed to confirm these data in larger multicentric populations, focusing on advanced imaging analysis and novel biomarkers or genetic status aiming to provide novel insights in this field.
