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Circulating serum tenascin-C(an extracellular matrix glycoprotein) levels in patients with idiopathic dilated cardiomyopathy(IDC) were measured. Serum tenasc in-C levels were increased in proportion to the severity of left ventricular dy sfunction in patients with IDC. The associations of serum tenascin-C levels wit h serum troponin T and procollagen type III aminoterminal peptide levels suggest that increased levels of serum tenascin-C indicate ongoing replacement fibrosi s after myocardial damage in IDC.