WJD-10-490.pdf (3.78 MB)
Diabetic cardiomyopathy: Pathophysiology, theories and evidence to date
journal contribution
posted on 2020-05-21, 15:25 authored by Lavanya Athithtan, Gaurav S Gulsin, Gerald P McCann, Eylem LeveltThe prevalence of type 2 diabetes (T2D) has increased worldwide and doubled over the last two decades. It features among the top 10 causes of mortality and morbidity in the world. Cardiovascular disease is the leading cause of complications in diabetes and within this, heart failure has been shown to be the leading cause of emergency admissions in the United Kingdom. There are many hypotheses and well-evidenced mechanisms by which diabetic cardiomyopathy as an entity develops. This review aims to give an overview of these mechanisms, with particular emphasis on metabolic inflexibility. T2D is associated with inefficient substrate utilisation, an inability to increase glucose metabolism and dependence on fatty acid oxidation within the diabetic heart resulting in mitochondrial uncoupling, glucotoxicity, lipotoxicity and initially subclinical cardiac dysfunction and finally in overt heart failure. The review also gives a concise update on developments within clinical imaging, specifically cardiac magnetic resonance studies to characterise and phenotype early cardiac dysfunction in T2D. A better understanding of the pathophysiology involved provides a platform for targeted therapy in diabetes to prevent the development of early heart failure with preserved ejection fraction.
History
Citation
World J Diabetes 2019; 10(10): 490-510Author affiliation
Department of Cardiovascular SciencesVersion
- VoR (Version of Record)
Published in
World Journal of DiabetesVolume
10Issue
10Pagination
490 - 510Publisher
Baishideng Publishing Groupissn
1948-9358eissn
1948-9358Acceptance date
2019-09-25Copyright date
2019Available date
2019-10-15Publisher DOI
Publisher version
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United StatesLanguage
EnglishUsage metrics
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Science & TechnologyLife Sciences & BiomedicineEndocrinology & MetabolismDiabetic cardiomyopathyCardiac metabolismMyocardial steatosisMyocardial strainCORONARY MICROVASCULAR DYSFUNCTIONBLOOD-GLUCOSE CONTROLSUBCLINICAL DIASTOLIC DYSFUNCTIONMYOCARDIAL TRIGLYCERIDE CONTENTENDOTHELIAL-CELL DYSFUNCTIONLEFT-VENTRICULAR HYPERTROPHYENERGY SUBSTRATE METABOLISMCONGESTIVE-HEART-FAILURECARDIOVASCULAR OUTCOMESFATTY-ACID
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