Ischemic cardiomyopathy pathophysiology?

Hi,

I am having a bit of trouble understanding why CAD/ischemia would result in cardiomyopathy- from my understanding, the CAD results in O2 supply/demand mismatch, but then the heart dilates to pump more to increase O2 supply?

But ultimately we still end with decreased ability to pump when you have dilated cardiomyopathy, so why does it dilate? Is it bc DCM temporarily provides ischemic relief due to the Frank-starling effect, but then gives out ultimately?

Best,

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Ischemic cardiomyopathy pathophysiology?