Diabetic cardiomyopathy

Author:

Asghar Omar1,Al-Sunni Ahmed2,Khavandi Kaivan2,Khavandi Ali3,Withers Sarah2,Greenstein Adam2,Heagerty Anthony M.2,Malik Rayaz A.2

Affiliation:

1. The Manchester Heart Centre, Manchester Royal Infirmary, Manchester M13 9WL, U.K.

2. Cardiovascular Research Group, Department of Medicine, Manchester Royal Infirmary and University of Manchester, Manchester M13 9NT, U.K.

3. The Bristol Heart Institute, Bristol Royal Infirmary and University of Bristol, Bristol BS1 3NU, U.K.

Abstract

Diabetic cardiomyopathy is a distinct primary disease process, independent of coronary artery disease, which leads to heart failure in diabetic patients. Epidemiological and clinical trial data have confirmed the greater incidence and prevalence of heart failure in diabetes. Novel echocardiographic and MR (magnetic resonance) techniques have enabled a more accurate means of phenotyping diabetic cardiomyopathy. Experimental models of diabetes have provided a range of novel molecular targets for this condition, but none have been substantiated in humans. Similarly, although ultrastructural pathology of the microvessels and cardiomyocytes is well described in animal models, studies in humans are small and limited to light microscopy. With regard to treatment, recent data with thiazoledinediones has generated much controversy in terms of the cardiac safety of both these and other drugs currently in use and under development. Clinical trials are urgently required to establish the efficacy of currently available agents for heart failure, as well as novel therapies in patients specifically with diabetic cardiomyopathy.

Publisher

Portland Press Ltd.

Subject

General Medicine

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