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This publication constitutes the outcome of an ESRF meeting held together with the German Research Foundation. Clinical researchers, immunologists, virologists and molecular biologists provide the latest findings in their fields, advancing our understanding of what causes chronic viral and inflammatory cardiomyopathy, why it affects a subset of individuals while sparing the majority, how we can develop better therapies, and whether the disease can be prevented. Special emphasis is placed on the role of viruses in the aetiology and pathogenesis of cardiomyopathy.