Diabetic Cardiomyopathy: A New Perspective of Mechanistic Approach

Abstract

Diabetic cardiomyopathy (DCM), one among the macrovascular complications of diabetes is the leading cause of mortality around the globe. The emergence of DCM irrespective of other cardiovascular diseases (CVD) necessitates a deeper insight into its occurrence and mechanism of development. This review summarizes the different stages in DCM progression based on molecular, cellular and functional level. The early stage in DCM involves oxidative stress and endoplasmic reticulum stress concomitant with O-linked glycosylation of receptors, and extracellular matrix (ECM) proteins, and formation of advanced glycation end products (AGE). This further influences myocyte apoptosis and steatosis, which is followed by fibrosis and remodeling, thus altering the physiological functioning of heart. It has been postulated that, microbuminuria (MA) which is an indicator of renal failure is also an early predictor of DCM. Currently, focus on epigenetic modifications, as observed in diabetics with renal failure is of critical importance to unveil the mystery behind the association of DCM and MA. Albeit, we examine DCM in a mechanistic approach, the major reason that remains unnoticed is glycemic excursion (GE). ACCORD, DCCT and EDIC studies have reported that the persistent effect in CVD is due to transient hyperglycemia. Hence it is predicted that, treatment strategies focusing on genetic level, along with maintaining persistent blood glucose would be more effectual. Besides, designing treatment regimen for patients with renal failure would be a preventive strategy for diabetic cardiomyopathy when their state towards DCM incidence is also considered and monitored precisely.

The Chinese Herb Yi‐Qi‐Huo‐Xue Protects Cardiomyocyte Function in Diabetic Cardiomyopathy

“…Myocardial cell apoptosis is an important pathophysiological mechanism in DCM. Apoptosis, also known as programmed cell death, plays an important role in maintaining the normal morphology and function of tissues and organs; DCM researcher has focused on the protein expression of apoptosis-related genes in cardiomyocytes [19–21]. The Bcl-2 family of proteins plays an important role in the process of apoptosis.…”

Diabetes-induced chronic heart failure is due to defects in calcium transporting and regulatory contractile proteins: cellular and molecular evidence

“…In progressive heart failure, structural remodelling and lowered cardiac efficiency -through elements such as elevated angiotensin II -promote cardiac wall stress. The result is a migration of Cx43 from cell poles to the lateral membrane leading to dyssynchronous contraction and further cardiac deterioration [75]. Joshi et al studied connexin in cardiac cardiomyopathy and demonstrated increased tyrosine nitration of Cx43 was linked to impaired functioning of the channels.…”

Механізми Реалізації Кардіопротективних Ефектів Метформіну (Огляд Літератури)

“…Діабетична кардіоміопатія. ДКМ є однією з основних причин термінальної стадії СН, що часто призводить до раптової зупинки серця та смерті [8]. Її розвиток є багатофакторним і включає такі механізми, як метаболічні порушення, резистентність до інсуліну, мікросудинні ураження, зміни в системі ренін-ангіотензину, вегетативна дисфункція серця та фіброз міокарда [9].…”