**Abstract**

Dilated cardiomyopathy (DCM) is an intractable disease that progressively worsens with cardiac enlargement and heart failure. There are approximately 20,000 patients designated with intractable disease who have moderate or severe heart failure symptoms even with appropriate medical treatment, making it the most common target disease for heart transplantation in Japan. Sixty percent of designated DCM patients are over the age of 60. If we can extend their healthy life expectancy by 5 to 10 years, we can reduce the number of patients who are candidates for heart transplantation. We have developed a patient-specific cardiac reshaping net (PS-CRN) to prevent progressive cardiac enlargement (=cardiac remodeling), which is the major factor in worsening heart failure. We have conducted three first-in-human clinical trials. The past and present of the "cardiac support net therapy" will be reviewed.

**Keywords:** dilated cardiomyopathy, cardiac remodeling, cardiac remodeling, heart failure with reduced ejection fraction (HFrEF), left ventricular end-diastolic pressure-volume relationship, right ventricular diastolic function, functional mitral regurgitation, precision medicine
