Diabetic cardiomyopathy: a hyperglycaemia- and insulin-resistance-induced heart disease

Diabetic cardiomyopathy is characterised in its early stages by diastolic relaxation abnormalities and later by clinical heart failure in the absence of dyslipidaemia, hypertension and coronary artery disease. Insulin resistance, hyperinsulinaemia and hyperglycaemia are each independent risk factors...

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Vydáno v:	Diabetologia Ročník 61; číslo 1; s. 21 - 28
Hlavní autoři:	Jia, Guanghong, Whaley-Connell, Adam, Sowers, James R.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Berlin/Heidelberg Springer Berlin Heidelberg 01.01.2018 Springer Nature B.V
Témata:	Aldosterone Angiotensin Animals Cardiomyopathy Cardiovascular disease Coronary artery Coronary artery disease Diabetes Diabetes mellitus Diabetic Cardiomyopathies - blood Diabetic Cardiomyopathies - physiopathology Disease resistance Dyslipidemia Endothelial cells Exosomes Fibrosis Heart diseases Heart Diseases - blood Heart Diseases - physiopathology Heart failure Human Physiology Humans Hyperglycemia Hyperglycemia - blood Hyperglycemia - physiopathology Immunomodulation Insulin Insulin resistance Insulin Resistance - physiology Internal Medicine Medicine Medicine & Public Health Metabolic Diseases Metabolic rate Oxidative stress Renin Review Risk factors Heart failure Insulin resistance Hyperglycaemia Review Cardiac dysfunction
ISSN:	0012-186X, 1432-0428, 1432-0428
On-line přístup:	Získat plný text
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Abstract	Diabetic cardiomyopathy is characterised in its early stages by diastolic relaxation abnormalities and later by clinical heart failure in the absence of dyslipidaemia, hypertension and coronary artery disease. Insulin resistance, hyperinsulinaemia and hyperglycaemia are each independent risk factors for the development of diabetic cardiomyopathy. The pathophysiological factors in diabetes that drive the development of cardiomyopathy include systemic metabolic disorders, inappropriate activation of the renin–angiotensin–aldosterone system, subcellular component abnormalities, oxidative stress, inflammation and dysfunctional immune modulation. These abnormalities collectively promote cardiac tissue interstitial fibrosis, cardiac stiffness/diastolic dysfunction and, later, systolic dysfunction, precipitating the syndrome of clinical heart failure. Recent evidence has revealed that dysregulation of coronary endothelial cells and exosomes also contributes to the pathology behind diabetic cardiomyopathy. Herein, we review the relationships among insulin resistance/hyperinsulinaemia, hyperglycaemia and the development of cardiac dysfunction. We summarise the current understanding of the pathophysiological mechanisms in diabetic cardiomyopathy and explore potential preventative and therapeutic strategies.
AbstractList	Diabetic cardiomyopathy is characterised in its early stages by diastolic relaxation abnormalities and later by clinical heart failure in the absence of dyslipidaemia, hypertension and coronary artery disease. Insulin resistance, hyperinsulinaemia and hyperglycaemia are each independent risk factors for the development of diabetic cardiomyopathy. The pathophysiological factors in diabetes that drive the development of cardiomyopathy include systemic metabolic disorders, inappropriate activation of the renin–angiotensin–aldosterone system, subcellular component abnormalities, oxidative stress, inflammation and dysfunctional immune modulation. These abnormalities collectively promote cardiac tissue interstitial fibrosis, cardiac stiffness/diastolic dysfunction and, later, systolic dysfunction, precipitating the syndrome of clinical heart failure. Recent evidence has revealed that dysregulation of coronary endothelial cells and exosomes also contributes to the pathology behind diabetic cardiomyopathy. Herein, we review the relationships among insulin resistance/hyperinsulinaemia, hyperglycaemia and the development of cardiac dysfunction. We summarise the current understanding of the pathophysiological mechanisms in diabetic cardiomyopathy and explore potential preventative and therapeutic strategies. Diabetic cardiomyopathy is characterised in its early stages by diastolic relaxation abnormalities and later by clinical heart failure in the absence of dyslipidaemia, hypertension and coronary artery disease. Insulin resistance, hyperinsulinaemia and hyperglycaemia are each independent risk factors for the development of diabetic cardiomyopathy. The pathophysiological factors in diabetes that drive the development of cardiomyopathy include systemic metabolic disorders, inappropriate activation of the renin-angiotensin-aldosterone system, subcellular component abnormalities, oxidative stress, inflammation and dysfunctional immune modulation. These abnormalities collectively promote cardiac tissue interstitial fibrosis, cardiac stiffness/diastolic dysfunction and, later, systolic dysfunction, precipitating the syndrome of clinical heart failure. Recent evidence has revealed that dysregulation of coronary endothelial cells and exosomes also contributes to the pathology behind diabetic cardiomyopathy. Herein, we review the relationships among insulin resistance/hyperinsulinaemia, hyperglycaemia and the development of cardiac dysfunction. We summarise the current understanding of the pathophysiological mechanisms in diabetic cardiomyopathy and explore potential preventative and therapeutic strategies.Diabetic cardiomyopathy is characterised in its early stages by diastolic relaxation abnormalities and later by clinical heart failure in the absence of dyslipidaemia, hypertension and coronary artery disease. Insulin resistance, hyperinsulinaemia and hyperglycaemia are each independent risk factors for the development of diabetic cardiomyopathy. The pathophysiological factors in diabetes that drive the development of cardiomyopathy include systemic metabolic disorders, inappropriate activation of the renin-angiotensin-aldosterone system, subcellular component abnormalities, oxidative stress, inflammation and dysfunctional immune modulation. These abnormalities collectively promote cardiac tissue interstitial fibrosis, cardiac stiffness/diastolic dysfunction and, later, systolic dysfunction, precipitating the syndrome of clinical heart failure. Recent evidence has revealed that dysregulation of coronary endothelial cells and exosomes also contributes to the pathology behind diabetic cardiomyopathy. Herein, we review the relationships among insulin resistance/hyperinsulinaemia, hyperglycaemia and the development of cardiac dysfunction. We summarise the current understanding of the pathophysiological mechanisms in diabetic cardiomyopathy and explore potential preventative and therapeutic strategies.
Author	Sowers, James R. Jia, Guanghong Whaley-Connell, Adam
AuthorAffiliation	4 Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO, USA 1 Diabetes and Cardiovascular Research Center, University of Missouri School of Medicine, D109 Diabetes Center HSC, One Hospital Drive, Columbia, MO 65212, USA 5 Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, USA 3 Division of Nephrology and Hypertension, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA 2 Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, Columbia, MO, USA
AuthorAffiliation_xml	– name: 1 Diabetes and Cardiovascular Research Center, University of Missouri School of Medicine, D109 Diabetes Center HSC, One Hospital Drive, Columbia, MO 65212, USA – name: 3 Division of Nephrology and Hypertension, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA – name: 4 Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO, USA – name: 2 Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, Columbia, MO, USA – name: 5 Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, USA
Author_xml	– sequence: 1 givenname: Guanghong surname: Jia fullname: Jia, Guanghong email: Jiag@health.missouri.edu organization: Diabetes and Cardiovascular Research Center, University of Missouri School of Medicine, D109 Diabetes Center HSC, Research Service, Harry S Truman Memorial Veterans Hospital, Research Service – sequence: 2 givenname: Adam surname: Whaley-Connell fullname: Whaley-Connell, Adam organization: Diabetes and Cardiovascular Research Center, University of Missouri School of Medicine, D109 Diabetes Center HSC, Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, Division of Nephrology and Hypertension, Department of Medicine, University of Missouri School of Medicine – sequence: 3 givenname: James R. surname: Sowers fullname: Sowers, James R. email: Sowersj@health.missouri.edu organization: Diabetes and Cardiovascular Research Center, University of Missouri School of Medicine, D109 Diabetes Center HSC, Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Dalton Cardiovascular Research Center, University of Missouri
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Snippet	Diabetic cardiomyopathy is characterised in its early stages by diastolic relaxation abnormalities and later by clinical heart failure in the absence of...
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SubjectTerms	Aldosterone Angiotensin Animals Cardiomyopathy Cardiovascular disease Coronary artery Coronary artery disease Diabetes Diabetes mellitus Diabetic Cardiomyopathies - blood Diabetic Cardiomyopathies - physiopathology Disease resistance Dyslipidemia Endothelial cells Exosomes Fibrosis Heart diseases Heart Diseases - blood Heart Diseases - physiopathology Heart failure Human Physiology Humans Hyperglycemia Hyperglycemia - blood Hyperglycemia - physiopathology Immunomodulation Insulin Insulin resistance Insulin Resistance - physiology Internal Medicine Medicine Medicine & Public Health Metabolic Diseases Metabolic rate Oxidative stress Renin Review Risk factors
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Title	Diabetic cardiomyopathy: a hyperglycaemia- and insulin-resistance-induced heart disease
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Volume	61
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