Cardiomyopathy Program, Stony Brook University Health Sciences Center, Stony Brook, New York.

When considering the article by Goldberg and colleagues, it seems reasonable to request a change in the title to "Survival after the diagnosis of  heart failure."

Despite advances in echocardiography, magnetic resonance imaging, and the ability to perform an endomyocardial biopsy, the underlying etiology of nonischemic left ventricular (LV) dysfunction often eludes clinical detection.