Predictors and prevention of diabetic cardiomyopathy

Vishalakshi Chavali, Suresh C. Tyagi, Paras Kumar Mishra

Research output: Contribution to journalReview article

71 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)151-160
Number of pages10
JournalDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy
Volume6
DOIs
StatePublished - Apr 10 2013
Externally publishedYes

Fingerprint

Diabetic Cardiomyopathies
Type 2 Diabetes Mellitus
Heart Failure
Sedentary Lifestyle
High Fat Diet
Microvessels
Hyperlipidemias
MicroRNAs
Glycogen
Cardiac Myocytes
Compliance
Extracellular Matrix
Insulin Resistance
Coronary Artery Disease

Keywords

  • Diabetes
  • Exercise
  • Heart failure
  • MiRNA
  • Obesity
  • Oxidative stress

ASJC Scopus subject areas

  • Internal Medicine
  • Pharmacology

Cite this

Predictors and prevention of diabetic cardiomyopathy. / Chavali, Vishalakshi; Tyagi, Suresh C.; Mishra, Paras Kumar.

In: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol. 6, 10.04.2013, p. 151-160.

Research output: Contribution to journalReview article

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