Diabetic Cardiomyopathy: Intersection of Macrovascular and Microvascular Disease, or Much More?

Abstract Cardiovascular disease is responsible for over 75% of deaths in diabetic patients, the majority caused by coronary artery disease (CAD) and heart failure. Cardiovascular morbidity and mortality in diabetic patients might be independently associated with other pathophysiologic mechanisms than coronary artery disease, epicardial and microvascular disease. There is an increasing notion that diabetic patients suffer from an additional cardiac condition named “diabetic cardiomyopathy”. There are several clinical, experimental, pathological and epidemiological researches that support the existence of a specific “diabetic cardiomyopathy”. This is assumed to be influenced by complex interaction of several metabolic changes that leads to both functional and structural alterations of the diabetic myocardium. In this review epidemiological aspects and clinical implications of this condition are presented.

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Index of microvascular resistance: A new effective tool to explore microvascular disease correlated with myocardial ischemia in diabetic patients without significant coronary artery disease

International Journal of Cardiology ◽

10.1016/j.ijcard.2012.11.104 ◽

2013 ◽

Vol 165 (3) ◽

pp. e57-e59 ◽

Cited By ~ 1

Author(s):

Jonathan Dupont ◽

Bénédicte Gaborit ◽

Blandine Simonnet ◽

Stéphanie Deffarges ◽

Jacques Quilici ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Myocardial Ischemia ◽

Significant Coronary Artery Disease ◽

Microvascular Disease ◽

Diabetic Patients ◽

Index Of Microvascular Resistance ◽

Artery Disease ◽

Microvascular Resistance

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Poor outcome of diabetic patients with coronary artery disease and coexisting heart failure

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(08)60052-1 ◽

2008 ◽

Vol 7 ◽

pp. 19-19

Author(s):

B PONIKOWSKA ◽

E JANKOWSKA ◽

K WEGRZYNOWSKATEODORCZYK ◽

S POWIERZA ◽

L BORODULINNADZIEJA ◽

...

Keyword(s):

Heart Failure ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Diabetic Patients ◽

Poor Outcome ◽

Artery Disease

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Evaluation of aortic arch calcification in type 2 diabetic patients

VASA ◽

10.1024/0301-1526.34.2.113 ◽

2005 ◽

Vol 34 (2) ◽

pp. 113-117 ◽

Cited By ~ 4

Author(s):

Papanas ◽

Symeonidis ◽

Maltezos ◽

Giannakis ◽

Mavridis ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Aortic Arch ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Insulin Dependence ◽

Artery Disease ◽

Type 2 Diabetic ◽

Aortic Arch Calcification

Background: The purpose of this study is to evaluate the severity of aortic arch calcification among type 2 diabetic patients in association with diabetes duration, diabetic complications, coronary artery disease and presence of cardiovascular risk factors. Patients and methods: This study included 207 type 2 diabetic patients (101 men) with a mean age of 61.5 ± 8.1 years and a mean diabetes duration of 13.9 ± 6.4 years. Aortic arch calcification was assessed by means of posteroanterior chest X-rays. Severity of calcification was graded as follows: grade 0 (no visible calcification), grade 1 (small spots of calcification or single thin calcification of the aortic knob), grade 2 (one or more areas of thick calcification), grade 3 (circular calcification of the aortic knob). Results: Severity of calcification was grade 0 in 84 patients (40.58%), grade 1 in 64 patients (30.92%), grade 2 in 43 patients (20.77%) and grade 3 in 16 patients (7.73%). In simple regression analysis severity of aortic arch calcification was associated with age (p = 0.032), duration of diabetes (p = 0.026), insulin dependence (p = 0.042) and presence of coronary artery disease (p = 0.039), hypertension (p = 0.019), dyslipidaemia (p = 0.029), retinopathy (p = 0.012) and microalbuminuria (p = 0.01). In multiple regression analysis severity of aortic arch calcification was associated with age (p = 0.04), duration of diabetes (p = 0.032) and presence of hypertension (p = 0.024), dyslipidaemia (p = 0.031) and coronary artery disease (p = 0.04), while the association with retinopathy, microalbuminuria and insulin dependence was no longer significant. Conclusions: Severity of aortic arch calcification is associated with age, diabetes duration, diabetic complications (retinopathy, microalbuminuria), coronary artery disease, insulin dependence, and presence of hypertension and dyslipidaemia.

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