Diabetic cardiomyopathy: understanding the molecular and cellular basis to progress in diagnosis and treatment

• Tipo: Artigo em Revista Científica Internacional
• Data: 2012

Autores

Falcao Pires, I (Autor) FMUP; Leite-Moreira AF (Autor) FMUP

Revista

Título: Heart Failure Reviews

Vol. 17

Páginas: 325-344

ISSN: 1382-4147

Editora: Springer Nature

Indexação

ISI Web of Knowledge - 275 Citações

Scopus - 294 Citações

Outras Informações

ID Authenticus: P-002-ARZ

DOI: 10.1007/s10741-011-9257-z

Abstract (EN): Diabetes mellitus is an important and prevalent risk factor for congestive heart failure. Diabetic cardiomyopathy has been defined as ventricular dysfunction that occurs in diabetic patients independent of a recognized cause such as coronary artery disease or hypertension. The disease course consists of a hidden subclinical period, during which cellular structural insults and abnormalities lead initially to diastolic dysfunction, later to systolic dysfunction, and eventually to heart failure. Left ventricular hypertrophy, metabolic abnormalities, extracellular matrix changes, small vessel disease, cardiac autonomic neuropathy, insulin resistance, oxidative stress, and apoptosis are the most important contributors to diabetic cardiomyopathy onset and progression. Hyperglycemia is a major etiological factor in the development of diabetic cardiomyopathy. It increases the levels of free fatty acids and growth factors and causes abnormalities in substrate supply and utilization, calcium homeostasis, and lipid metabolism. Furthermore, it promotes excessive production and release of reactive oxygen species, which induces oxidative stress leading to abnormal gene expression, faulty signal transduction, and cardiomyocytes apoptosis. Stimulation of connective tissue growth factor, fibrosis, and the formation of advanced glycation end-products increase the stiffness of the diabetic hearts. Despite all the current information on diabetic cardiomyopathy, translational research is still scarce due to limited human myocardial tissue and most of our knowledge is extrapolated from animals. This paper aims to elucidate some of the molecular and cellular pathophysiologic mechanisms, structural changes, and therapeutic strategies that may help struggle against diabetic cardiomyopathy.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 20