| Outcome Measures: |
Primary: Change from Baseline in Left Ventricular torsion (°) at 5 months, Change of Left ventricular torsion (°) assessed through CMR with tagging before and after treatment to heart failure and gender differences, time 0, +5 months | Secondary: Change from baseline in cardiac shortening (Strain %) at 5 months, Change of cardiac strain (%) and of parameters of cardiac geometry and performance assessed through CMR with tagging before and after treatment and gender differences, time 0, + 5 months|Change from baseline in Myocardial fibrosis at 5 months, Quantification of Myocardial fibrosis assessed with T1-mapping to establish a new parametersfor the characterization of DCM and treatment efficacy, assessed through CMR before and after treatment and gender differences, time 0, +5 months|Change from baseline in Circulating pro-fibrotic and pro-inflammatory chemokines at 5 months, Assessment of circulating pro-fibrotic and pro-inflammatory chemokines and correlation to torsion, strain and fibrosis at time 0 and after treatment (markers predictors of disease progression and treatment efficacy) and differences in genders, Time 0, +5 months|Peripheral immunological profile, Evaluation of immune function and circulating and cellular angiogenesis mediators predictive of disease progression and PDE5Ai treatment efficacy, time 0 and +5 months|Gender differences in molecular, immunological and cardiac morpho-functional profile., Identify gender differences in molecular, immunological and imaging characterization of the DCM., time 0 and +5 months|Effects of PDE5i on diabetic neuropathy, Identify possible effects of chronic treatment with PDE5i on diabetic neuropathy, time 0 and +5 months|Effects of PDE5i on diabetic nephropathy, Identify possible effects of chronic treatment with PDE5i on diabetic nephropathy, time 0 and +5 months|Effects of PDE5i on Body composition, Evaluation of the effect of PDE5Ai on body composition evaluated by DEXA scan., time 0 and +5 months
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