Year: 2020
Type: review
Abstract: Diabetes mellitus predisposes affected individuals to a significant spectrum of cardiovascular complications, one of the most debilitating in terms of prognosis is heart failure. Indeed, the increasing global prevalence of diabetes mellitus and an aging population has given rise to an epidemic of diabetes mellitus-induced heart failure. Despite the significant research attention this phenomenon, termed diabetic cardiomyopathy, has received over several decades, understanding of the full spectrum of potential contributing mechanisms, and their relative contribution to this heart failure phenotype in the specific context of diabetes mellitus, has not yet been fully resolved. Key recent preclinical discoveries that comprise the current state-of-the-art understanding of the basic mechanisms of the complex phenotype, that is, the diabetic heart, form the basis of this review. Abnormalities in each of cardiac metabolism, physiological and pathophysiological signaling, and the mitochondrial compartment, in addition to oxidative stress, inflammation, myocardial cell death pathways, and neurohumoral mechanisms, are addressed. Further, the interactions between each of these contributing mechanisms and how they align to the functional, morphological, and structural impairments that characterize the diabetic heart are considered in light of the clinical context: from the disease burden, its current management in the clinic, and where the knowledge gaps remain. The need for continued interrogation of these mechanisms (both known and those yet to be identified) is essential to not only decipher the how and why of diabetes mellitus-induced heart failure but also to facilitate improved inroads into the clinical management of this pervasive clinical challenge.
Source: Circulation Research
Authors: Rebecca H. Ritchie, E. Dale Abel
Institutions: Monash University, University of Iowa
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Awards: Insulin Resistance and Myocardial Autophagy, Insulin resistance and cardiac dysfunction in obesity, Modeling Diabetic Cardiomyopathy and Microangiopathy , Insulin Signaling and the Heart in Diabetes, OPA1 an Estrogen-Mediated Modulator of Platelet Hyperactivation, Insulin Inhibition of beta-AR Signaling in the Myocardium, OPA1 an Estrogen-Mediated Modulator of Platelet Hyperactivation, Targeting Antioxidant Therapy to Cardiac Mitochondria, Cardiac Dysfunction in the Met Syndrome: Cross-talk between IR and bAR Signaling, Insulin Signaling and the Heart in Diabetes
OpenAlex ID: W3026907472