Specifics of the diagnosis and treatment of diabetic cardiomyopathy

2020 ◽  
pp. 55-62
Author(s):  
Vsevolod Skvortsov ◽  
Anzhela Borisova
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Diabetic Cardiomyopathy ◽  
Severe Heart Failure ◽  
Diagnosis And Treatment ◽  
Shortness Of Breath ◽  
Pathological Changes ◽  
Electrolyte Disorders ◽  
Clinical Pictures

A complex of pathological changes in heart that are caused by metabolic, vascular and electrolyte disorders during diabetes mellitus is called diabetic cardiomyopathy. The clinical pictures of this condition can be diverse — from an asymptomatic course to severe heart failure with shortness of breath, edema, cardialgia, acrocyanosis.

scholarly journals Effective Treatment of Diabetic Cardiomyopathy and Heart Failure with Reconstituted HDL (Milano) in Mice

2019 ◽  
Vol 20 (6) ◽  
pp. 1273 ◽  
Author(s):  
Joseph Aboumsallem ◽  
Ilayaraja Muthuramu ◽  
Mudit Mishra ◽  
Herman Kempen ◽  
Bart De Geest
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Effective Treatment ◽  
Diabetic Cardiomyopathy ◽  
Capillary Density ◽  
Loop Analysis ◽  
Lung Weight

The risk of heart failure (HF) is prominently increased in patients with type 2 diabetes mellitus. The objectives of this study were to establish a murine model of diabetic cardiomyopathy induced by feeding a high-sugar/high-fat (HSHF) diet and to evaluate the effect of reconstituted HDLMilano administration on established HF in this model. The HSHF diet was initiated at the age of 12 weeks and continued for 16 weeks. To investigate the effect of reconstituted HDLMilano on HF, eight intraperitoneal administrations of MDCO-216 (100 mg/kg protein concentration) or of an identical volume of control buffer were executed with a 48-h interval starting at the age of 28 weeks. The HSHF diet-induced obesity, hyperinsulinemia, and type 2 diabetes mellitus. Diabetic cardiomyopathy was present in HSHF diet mice as evidenced by cardiac hypertrophy, increased interstitial and perivascular fibrosis, and decreased myocardial capillary density. Pressure-volume loop analysis indicated the presence of both systolic and diastolic dysfunction and of decreased cardiac output in HSHF diet mice. Treatment with MDCO-216 reversed pathological remodelling and cardiac dysfunction and normalized wet lung weight, indicating effective treatment of HF. No effect of control buffer injection was observed. In conclusion, reconstituted HDLMilano reverses HF in type 2 diabetic mice.

scholarly journals Diabetic cardiomyopathy: factual or factoid?

2019 ◽  
Vol 65 (1) ◽  
pp. 61-69
Author(s):  
Thiago Quinaglia ◽  
Daniela C. Oliveira ◽  
José Roberto Matos-Souza ◽  
Andrei C. Sposito
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Diabetic Cardiomyopathy ◽  
Glucose Transporter ◽  
Epidemiological Evidence ◽  
Glucose Lowering ◽  
Reduced Ejection Fraction ◽  
Prevention And Treatment ◽  
Relationship Of ◽  
The Relationship

SUMMARY Although long ago described, there is no established consensus regarding the real existence of Diabetic Cardiomyopathy (CMPDM). Due to its complex pathophysiology, it has been difficult for clinical and experimental research to establish clear connections between diabetes mellitus (DM) and heart failure (HF), as well as to solve the mechanisms of the underlying myocardial disease. However, the epidemiological evidence of the relationship of these conditions is undisputed. The interest in understanding this disease has intensified due to the recent results of clinical trials evaluating new glucose-lowering drugs, such as sodium-glucose transporter inhibitors 2, which demonstrated favorable responses considering the prevention and treatment of HF in patients with DM. In this review we cover aspects of the epidemiology of CMPDM and its possible pathogenic mechanisms, as well as, present the main cardiac phenotypes of CMPDM (HF with preserved and reduced ejection fraction) and implications of the therapeutic management of this disease.

The vulnerable myocardium

2015 ◽  
Vol 35 (01) ◽  
pp. 17-24 ◽  
Author(s):  
C. Bode ◽  
H. Bugger
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Diabetic Cardiomyopathy ◽  
Cardiac Complications ◽  
Artery Disease ◽  
Increased Susceptibility

SummaryCardiovascular disease is the major cause of morbidity and mortality in subjects suffering from diabetes mellitus. While coronary artery disease is the leading cause of cardiac complications in diabetics, it is widely recognized that diabetes increases the risk for the development of heart failure independently of coronary heart disease and hypertension. This increased susceptibility of the diabetic heart to develop structural and functional impairment is termed diabetic cardiomyopathy. The number of different mechanisms proposed to contribute to diabetic cardiomyopathy is steadily increasing and underlines the complexity of this cardiac entity.In this review the mechanisms that account for the increased myocardial vulnerability in diabetic cardiomyopathy are discussed.

scholarly journals Dostig ja vysshei vlasti: Feodor Chaliapin's illness and death

2020 ◽  
Vol 1 (3) ◽  
pp. 6-22
Author(s):  
Leonid I. Dvoretsky ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Acute Leukemia ◽  
Respiratory Infections ◽  
Severe Heart Failure ◽  
Recurrent Respiratory Infections

The article provides data on the nature and course of the disease of F.I. Chaliapin, who suffered from diabetes mellitus with the development of recurrent respiratory infections, severe heart failure. The possibility of developing acute leukemia in the last year of the singer's life is discussed.

scholarly journals Mitochondrial Dysfunction in Diabetic Cardiomyopathy: The Possible Therapeutic Roles of Phenolic Acids

2020 ◽  
Vol 21 (17) ◽  
pp. 6043
Author(s):  
Fatin Farhana Jubaidi ◽  
Satirah Zainalabidin ◽  
Vanitha Mariappan ◽  
Siti Balkis Budin
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Mitochondrial Dysfunction ◽  
Phenolic Acids ◽  
Diabetic Cardiomyopathy ◽  
Future Development ◽  
Potential Role ◽  
Systolic Dysfunction ◽  
Main Factors

As the powerhouse of the cells, mitochondria play a very important role in ensuring that cells continue to function. Mitochondrial dysfunction is one of the main factors contributing to the development of cardiomyopathy in diabetes mellitus. In early development of diabetic cardiomyopathy (DCM), patients present with myocardial fibrosis, dysfunctional remodeling and diastolic dysfunction, which later develop into systolic dysfunction and eventually heart failure. Cardiac mitochondrial dysfunction has been implicated in the development and progression of DCM. Thus, it is important to develop novel therapeutics in order to prevent the progression of DCM, especially by targeting mitochondrial dysfunction. To date, a number of studies have reported the potential of phenolic acids in exerting the cardioprotective effect by combating mitochondrial dysfunction, implicating its potential to be adopted in DCM therapies. Therefore, the aim of this review is to provide a concise overview of mitochondrial dysfunction in the development of DCM and the potential role of phenolic acids in combating cardiac mitochondrial dysfunction. Such information can be used for future development of phenolic acids as means of treating DCM by alleviating the cardiac mitochondrial dysfunction.

scholarly journals Hyperglycemic memory in diabetic cardiomyopathy

2021 ◽  
Author(s):  
Jiabing Zhan ◽  
Chen Chen ◽  
Dao Wen Wang ◽  
Huaping Li
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Blood Glucose ◽  
Cardiovascular Diseases ◽  
Glycemic Control ◽  
Diabetic Cardiomyopathy ◽  
Cardiovascular Complication ◽  
Diabetes Therapy ◽  
Patients With Diabetes ◽  
Underlying Mechanisms

AbstractCardiovascular diseases account for approximately 80% of deaths among individuals with diabetes mellitus, with diabetic cardiomyopathy as the major diabetic cardiovascular complication. Hyperglycemia is a symptom that abnormally activates multiple downstream pathways and contributes to cardiac hypertrophy, fibrosis, apoptosis, and other pathophysiological changes. Although glycemic control has long been at the center of diabetes therapy, multicenter randomized clinical studies have revealed that intensive glycemic control fails to reduce heart failure-associated hospitalization and mortality in patients with diabetes. This finding indicates that hyperglycemic stress persists in the cardiovascular system of patients with diabetes even if blood glucose level is tightly controlled to the normal level. This process is now referred to as hyperglycemic memory (HGM) phenomenon. We briefly reviewed herein the current advances that have been achieved in research on the underlying mechanisms of HGM in diabetic cardiomyopathy.

scholarly journals Diabetic heart: Metabolic reasons for the development of cardiomyopathy

1996 ◽  
Vol 42 (6) ◽  
pp. 20-26
Author(s):  
E. I. Sokolov ◽  
O. S. Zaichikova
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Coronary Arteries ◽  
Diabetic Cardiomyopathy ◽  
Myocardial Dysfunction ◽  
Stroke Volume Index ◽  
Left Ventricular ◽  
Volume Index ◽  
Dependent Diabetes Mellitus ◽  
Patients With Diabetes

Cardiovascular disease is a common cause of death in patients with diabetes mellitus (DM). The likelihood of developing heart failure with this disease increases, even if you take into account the influence of factors such as age, blood pressure, plasma cholesterol, body weight and the condition of the coronary arteries. The term "diabetic cardiomyopathy" was proposed in 1972 by S. Rubier et al. They performed postmortem autopsy of patients with diabetes complicated by diabetic nephropathy and congestive heart failure without arterial hypertension and severe atherosclerosis of the coronary arteries. The hemodynamic parameters of a group of patients with diabetes without hypertension without significant atherosclerotic changes in the coronary arteries according to angiography were studied by T. Regan et al. In these patients, a decrease in stroke volume index and an increase in diastolic pressure in the left ventricle were detected. The observed changes, indicating a decrease in left ventricular myocardial extensibility, were interpreted as signs of subclinical cardiomyopathy. Based on the results of an echocardiographic examination of patients with insulin-dependent diabetes mellitus (IDDM) Ch. Dimitar proposed the following stages of development of diabetic cardiomyopathy: I - increased myocardial contractility; II - systolic and diastolic functions are not impaired; III - the beginning of the development of diastolic dysfunction, a decrease in the "compliance" of the left ventricular myocardium and dilatation of the left atrium; IV - progression of diastolic myocardial dysfunction (DDM) and the addition of systolic dysfunction.

Clinical picture, diagnosis and treatment of mitral valvular diseases

2021 ◽  
pp. 8-19
Author(s):  
Dmitriy Sergeevich Kovalev
Keyword(s):  
Heart Failure ◽  
Clinical Picture ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Heart Defects ◽  
Full Recovery ◽  
Diagnosis And Treatment ◽  
Pathological Changes ◽  
Valvular Diseases ◽  
Large Groups

Heart defects are pathological changes in the heart, during which the defects of the valve apparatus or its walls are observed, leading to heart failure. There are two large groups of heart defects: congenital and acquired. The diseases are chronic, slowly progressing; therapy only alleviates their course, but does not eliminate the cause of their occurrence; full recovery is possible only with surgical intervention. This article is devoted to the issues of classification, etiology, pathogenesis, clinical symptoms, approaches to the diagnosis and treatment of mitral valvular diseases.

scholarly journals A COMPREHENSIVE STUDY ON LITERATURE EVIDENCE, CLINICAL STUDIES AND PRACTICES OF HERBAL DRUGS FOR DIABETIC NEUROPATHY AND CARDIOMYOPATHY

2017 ◽  
Vol 10 (9) ◽  
pp. 30
Author(s):  
Arshiya Shamim ◽  
Hefazat Hussain Siddiqui ◽  
Tarique Mahmood ◽  
Paramdeep Bagga ◽  
Ranjan Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Diabetic Neuropathy ◽  
Diabetic Cardiomyopathy ◽  
Left Ventricular ◽  
Cardiac Autonomic Neuropathy ◽  
Diabetic Patients ◽  
Epidemic Disease ◽  
Complications Of Diabetes ◽  
Wide Range

  Diabetes mellitus is a worldwide epidemic disease that eventually advances to a chronic stage and affects different vital organs by intensifying the underlying pathological factors, and through the remodeling of the tissues by the generation of reactive oxygen species leading to the development of respective organ failure. Two such complications are painful neuropathy and cardiomyopathy; both of which are common and progressive complications of diabetes. The symptoms of peripheral neuropathy include tingling, burning, lancinating pain, hyperesthesia, and allodynia. The course of the disease progression may vary from intermittent, mild symptoms to severe chronic, and daily pain; which culminates into poor quality of life. Another complication of diabetes mellitus, diabetic cardiomyopathy, is defined as a ventricular dysfunction disorder that occurs in diabetic patients. The development of the disease is characterized by a hidden subclinical period, during which cellular, structural changes and abnormalities lead to diastolic dysfunction, followed by systolic dysfunction, and terminating into 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 pathological advancements that lead to diabetic cardiomyopathy. Various pharmaceutical agents from different pharmacological categories have been proposed for the symptomatic treatment of painful diabetic neuropathy; however, it is a herculean task to select a drug due to the wide range of choices and lack of consistent guidelines for treatment. Similarly, treatment of cardiomyopathy is based on the general therapeutic rules of management of heart failure and no specifications have yet been addressed for this condition. Therefore, more studies are required to improve our knowledge of these complex syndromes. From this perspective, this review is designed to delineate a general overview of neuropathy and cardiomyopathy, referring to the conventional therapies in use and possible unconventional, natural, herbal, and safe treatments for both the above-mentioned complications of diabetes.

Hydrogen sulfide: an old gas with new cardioprotective effects

2014 ◽  
Vol 128 (5) ◽  
pp. 321-323 ◽  
Author(s):  
Vaibhav B. Patel ◽  
Brent A. McLean ◽  
Xueyi Chen ◽  
Gavin Y. Oudit
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Hydrogen Sulfide ◽  
Diabetic Cardiomyopathy ◽  
Therapeutic Potential ◽  
Cardiovascular Complications ◽  
Signalling Pathways ◽  
Intracellular Signalling Pathways ◽  
Signalling Molecule ◽  
Cardioprotective Effects

Diabetic cardiovascular complications are reaching epidemic proportions and the risk of HF (heart failure) is increased 2–3-fold by diabetes mellitus. H2S (hydrogen sulfide) is emerging as a new gaseous signalling molecule in the cardiovascular system which possesses multifactorial effects on various intracellular signalling pathways. The proven cardioprotective and vasodilator activities of H2S warrant a detailed investigation into its role in diabetic cardiomyopathy. In the present issue of Clinical Science, Zhou et al. demonstrate an important therapeutic potential of the H2S pathway in diabetic cardiomyopathy.

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