Back to Browse Journals » Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy » Volume 6

Predictors and prevention of diabetic cardiomyopathy

Authors Chavali V, Tyagi SC, Mishra PK

Published Date April 2013 Volume 2013:6 Pages 151—160

DOI http://dx.doi.org/10.2147/DMSO.S30968

Received 27 November 2012, Accepted 28 February 2013, Published 11 April 2013

Vishalakshi Chavali, Suresh C Tyagi, Paras K Mishra

Department of Physiology and Biophysics, School of Medicine, University of Louisville, Louisville, Kentucky, USA

Abstract: Despite our cognizance that diabetes can enhance the chances of heart failure, causes multiorgan failure,and contributes to morbidity and mortality, it is rapidly increasing menace worldwide. Less attention has been paid to alert prediabetics through determining the comprehensive predictors of diabetic cardiomyopathy (DCM) and ameliorating DCM using novel approaches. DCM is recognized as asymptomatic progressing structural and functional remodeling in the heart of diabetics, in the absence of coronary atherosclerosis and hypertension. The three major stages of DCM are: (1) early stage, where cellular and metabolic changes occur without obvious systolic dysfunction; (2) middle stage, which is characterized by increased apoptosis, a slight increase in left ventricular size, and diastolic dysfunction and where ejection fraction (EF) is <50%; and (3) late stage, which is characterized by alteration in microvasculature compliance, an increase in left ventricular size, and a decrease in cardiac performance leading to heart failure. Recent investigations have revealed that DCM is multifactorial in nature and cellular, molecular, and metabolic perturbations predisposed and contributed to DCM. Differential expression of microRNA (miRNA), signaling molecules involved in glucose metabolism, hyperlipidemia, advanced glycogen end products, cardiac extracellular matrix remodeling, and alteration in survival and differentiation of resident cardiac stem cells are manifested in DCM. A sedentary lifestyle and high fat diet causes obesity and this leads to type 2 diabetes and DCM. However, exercise training improves insulin sensitivity, contractility of cardiomyocytes, and cardiac performance in type 2 diabetes. These findings provide new clues to diagnose and mitigate DCM. This review embodies developments in the field of DCM with the aim of elucidating the future perspectives of predictors and prevention of DCM.

Keywords: diabetes, obesity, exercise, heart failure, miRNA, oxidative stress

Download Article [PDF] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Readers of this article also read:

Management of limited joint mobility in diabetic patients

Abate M, Schiavone C, Salini V, Andia I

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2013, 6:197-207

Published Date: 7 May 2013

Treatment outcomes after initiation of exenatide twice daily or insulin in clinical practice: 12-month results from CHOICE in six European countries

Ostenson CG, Matthaei S, Reaney M, Krarup T, Guerci B, Kiljanski J, Salaun-Martin C, Sapin H, Bruhn D, Mathieu C, Theodorakis M

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2013, 6:171-185

Published Date: 26 April 2013