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Diabetic Cardiomyopathy Mechanisms Diagnosis And Treatment

Exercise Prevents Cardiac Injury And Improves Mitochondrial Biogenesis In Advanced Diabetic Cardiomyopathy With Pgc-1 And Akt Activation

Exercise Prevents Cardiac Injury And Improves Mitochondrial Biogenesis In Advanced Diabetic Cardiomyopathy With Pgc-1 And Akt Activation

Exercise Prevents Cardiac Injury and Improves Mitochondrial Biogenesis in Advanced Diabetic Cardiomyopathy with PGC-1 and Akt Activation Wang H.a Bei Y.b, c Lu Y.a Sun W.a Liu Q.d Wang Y.b, c Cao Y.b, c Chen P.b, c Xiao J.b, c Kong X.a aDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, bRegeneration and Ageing Lab and Experimental Center of Life Sciences, School of Life Science, Shanghai University, Shanghai, cShanghai Key Laboratory of Bio-Energy Crops, School of Life Science, Shanghai University, Shanghai, dDepartment of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, (China) and Regeneration and Ageing Lab and Experimental Center of Life Sciences, School of Life Science, Shanghai University, 333 Nan Chen Road, Shanghai 200444, (China) E-Mail [email protected], E-Mail [email protected] Background/Aims: Diabetic cardiomyopathy (DCM) represents the major cause of morbidity and mortality among diabetics. Exercise has been reported to be effective to protect the heart from cardiac injury during the development of DCM. However, the potential cardioprotective effect of exercise in advanced DCM remains unclear. Methods: Seven-week old male C57BL/6 wild-type or db/db mice were either subjected to a running exercise program for 15 weeks or kept sedentary. Cardiac function, myocardial apoptosis and fibrosis, and mitochondrial biogenesis were examined for evaluation of cardiac injury. Results: A reduction in ejection fraction and fractional shortening in db/db mice was significantly reversed by exercise training. DCM induced remarkable cardiomyocyte apoptosis and Continue reading >>

(pdf) Diabetic Cardiomyopathy: Mechanisms, Diagnosis And Treatment

(pdf) Diabetic Cardiomyopathy: Mechanisms, Diagnosis And Treatment

, Ahmed AL-SUNNI, Kaivan KHAVANDI, Ali KHAVANDI, Sarah WITHERS,AdamGREENSTEIN, Anthony M. HEAGERTY and Rayaz A. MALIK The Manchester Heart Centre, Manchester Royal Inrmary, Manchester M13 9WL, U.K., Cardiovascular Research Group, Department of Medicine, Manchester Royal Inrmary and University of Manchester, Manchester M13 9NT, U.K., and The Bristol Heart Institute, Bristol Royal Inrmary and University of Bristol, Bristol BS1 3NU, U.K. Diabetic cardiomyopathy is a distinct primary disease process, independent of coronary artery disease, which leads to heart failure in diabetic patients. Epidemiological and clinical trial data have conrmed the greater incidence and prevalence of heart failure in diabetes. Novel echocardiographic and MR (magnetic resonance) techniques have enabled a more accurate means of phenotyping diabetic cardiomyopathy. Experimental models of diabetes have provided a range of novel molecular targets for this condition, but none have been substantiated in humans. Similarly, although ultrastructural pathology of the microvessels and cardiomyocytes is well described in animal models, studies in humans are small and limited to light microscopy. With regard to treatment, recent data with thiazoledinediones has generated much controversy in terms of the cardiac safety of both these and other drugs currently in use and under development. Clinical trials are urgently required to establish the efcacy of currently available agents for heart failure, as well as novel therapies in patients specically with diabetic cardiomyopathy. The link between HF (heart failure) and diabetes is well documented, but the existence of diabetic cardiomyo- pathy as a distinct clinical entity continues to be the sub- ject of debate. In 1881, Leyden commented that HF was a frequent Continue reading >>

A New Insight Of Mechanisms, Diagnosis And Treatment Of Diabetic Cardiomyopathy

A New Insight Of Mechanisms, Diagnosis And Treatment Of Diabetic Cardiomyopathy

, Volume 41, Issue3 , pp 398409 | Cite as A new insight of mechanisms, diagnosis and treatment of diabetic cardiomyopathy Diabetes mellitus is one of the most common chronic diseases across the world. Cardiovascular complication is the major morbidity and mortality among the diabetic patients. Diabetic cardiomyopathy, a new entity independent of coronary artery disease or hypertension, has been increasingly recognized by clinicians and epidemiologists. Cardiac dysfunction is the major characteristic of diabetic cardiomyopathy. For a better understanding of diabetic cardiomyopathy and necessary treatment strategy, several pathological mechanisms such as impaired calcium handling and increased oxidative stress, have been proposed through clinical and experimental observations. In this review, we will discuss the development of cardiac dysfunction, the mechanisms underlying diabetic cardiomyopathy, diagnostic methods, and treatment options. Diabetic cardiomyopathyCardiac dysfunctionImpaired calcium handlingOxidative stressFatty acidIon channelDiagnosisTreatment This is a preview of subscription content, log in to check access Work in Professor Chens Lab discussed in this review has been supported by Australian NHMRC and Dept of Innovation, Industry, Science and Research, Commonwealth of Australia. H. King, R.E. Aubert, W.H. Herman, Global burden of diabetes, 19952025prevalence, numerical estimates, and projections. Diabetes Care 21(9), 14141431 (1998). doi: 10.2337/diacare.21.9.1414 PubMed CrossRef Google Scholar S. Rubler, Y.Z. Yuceoglu, T. Kumral, A. Grishman, A.W. Branwood, J. Dlugash, New type of cardiomyopathy associated with diabetic glomerulosclerosis. Am. J. Cardiol. 30(6), 595602 (1972). doi: 10.1016/0002-9149(72)90595-4 PubMed CrossRef Google Scholar T.J. Regan, Continue reading >>

Diagnostic Approaches For Diabetic Cardiomyopathy

Diagnostic Approaches For Diabetic Cardiomyopathy

Diagnostic approaches for diabetic cardiomyopathy Diabetic cardiomyopathy (DCM) is a cardiac dysfunction which affects approximately 12% of diabetic patients, leading to overt heart failure and death. However, there is not an efficient and specific methodology for DCM diagnosis, possibly because molecular mechanisms are not fully elucidated, and it remains asymptomatic for many years. Also, DCM frequently coexists with other comorbidities such as hypertension, obesity, dyslipidemia, and vasculopathies. Thus, human DCM is not specifically identified after heart failure is established. In this sense, echocardiography has been traditionally considered the gold standard imaging test to evaluate the presence of cardiac dysfunction, although other techniques may cover earlier DCM detection by quantification of altered myocardial metabolism and strain. In this sense, Phase-Magnetic Resonance Imaging and 2D/3D-Speckle Tracking Echocardiography may potentially diagnose and stratify diabetic patients. Additionally, this information could be completed with a quantification of specific plasma biomarkers related to related to initial stages of the disease. Cardiotrophin-1, activin A, insulin-like growth factor binding protein-7 (IGFBP-7) and Heart fatty-acid binding protein have demonstrated a stable positive correlation with cardiac hypertrophy, contractibility and steatosis responses. Thus, we suggest a combination of minimally-invasive diagnosis tools for human DCM recognition based on imaging techniques and measurements of related plasma biomarkers. Diabetic cardiomyopathyDiagnosisImagingBiomarker Cardiovascular pathologies are the most common cause of mortality in the world, and diabetes mellitus is one of the major risk factor for cardiovascular disease development [ 1 ]. By Continue reading >>

Clinical Diabetic Cardiomyopathy: A Two-faced Disease With Restrictive And Dilated Phenotypes

Clinical Diabetic Cardiomyopathy: A Two-faced Disease With Restrictive And Dilated Phenotypes

Clinical diabetic cardiomyopathy: a two-faced disease with restrictive and dilated phenotypes Institute for Cardiovascular Research VU (ICaR-VU) Van der Boechorststraat 7, 1081 BT Amsterdam Corresponding author. Tel: +31 20 4448110, Fax: +31 20 4448255, Email: [email protected] Search for other works by this author on: European Heart Journal, Volume 36, Issue 27, 14 July 2015, Pages 17181727, Petar M. Seferovi, Walter J. Paulus; Clinical diabetic cardiomyopathy: a two-faced disease with restrictive and dilated phenotypes, European Heart Journal, Volume 36, Issue 27, 14 July 2015, Pages 17181727, Diabetes mellitus-related cardiomyopathy (DMCMP) was originally described as a dilated phenotype with eccentric left ventricular (LV) remodelling and systolic LV dysfunction. Recently however, clinical studies on DMCMP mainly describe a restrictive phenotype with concentric LV remodelling and diastolic LV dysfunction. Both phenotypes are not successive stages of DMCMP but evolve independently to respectively heart failure with preserved left ventricular ejection fraction (HFPEF) or reduced left ventricular ejection fraction (HFREF). Phenotype-specific pathophysiological mechanisms were recently proposed for LV remodelling and dysfunction in HFPEF and HFREF consisting of coronary microvascular endothelial dysfunction in HFPEF and cardiomyocyte cell death in HFREF. A similar preferential involvement of endothelial or cardiomyocyte cell compartments explains DMCMP development into distinct restrictive/HFPEF or dilated/HFREF phenotypes. Diabetes mellitus (DM)-related metabolic derangements such as hyperglycaemia, lipotoxicity, and hyperinsulinaemia favour development of DMCMP with restrictive/HFPEF phenotype, which is more prevalent in obese type 2 DM patients. In contrast, autoimm Continue reading >>

Diabetic Cardiomyopathy: Mechanisms, Diagnosis And Treatment.

Diabetic Cardiomyopathy: Mechanisms, Diagnosis And Treatment.

Diabetic cardiomyopathy: mechanisms, diagnosis and treatment. Department of Cardiology, Northwick Park Hospital, Watford Road, Harrow HAI 3UJ, UK. Independent of the severity of coronary artery disease, diabetic patients have an increased risk of developing heart failure. This clinical entity has been considered to be a distinct disease process referred to as 'diabetic cardiomyopathy'. Experimental studies suggest that extensive metabolic perturbations may underlie both functional and structural alterations of the diabetic myocardium. Translational studies are, however, limited and only partly explain why diabetic patients are at increased risk of cardiomyopathy and heart failure. Although a range of diagnostic methods may help to characterize alterations in cardiac function in general, none are specific for the alterations in diabetes. Treatment paradigms are very much limited to interpretation and translation from the results of interventions in non-diabetic patients with heart failure. This suggests that there is an urgent need to conduct pathogenetic, diagnostic and therapeutic studies specifically in diabetic patients with cardiomyopathy to better understand the factors which initiate and progress diabetic cardiomyopathy and to develop more effective treatments. Continue reading >>

Diabetic Cardiomyopathy: Is Resistin A Culprit?

Diabetic Cardiomyopathy: Is Resistin A Culprit?

Diabetic cardiomyopathy: is resistin a culprit? Diabetic cardiomyopathy: is resistin a culprit? Diabetic cardiomyopathy: is resistin a culprit? Cardiovascular Research Institute, Graduate School of Biological Sciences, Department of Medicine, Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, Correspondence to: Djamel Lebeche. Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA. Email: Abstract: Cardiovascular disease, including heart failure (HF), is the major cause of death in patients with diabetes. A contributing factor to the occurrence of HF in such patients is the development of diabetic cardiomyopathy. Recent evidence demonstrates that perturbations associated with adipokines secretion and signaling result in lusitropic and inotropic defects in diabetic cardiomyopathy. This perspective editorial will discuss the central role of resistin, a recently discovered adipokine, in the maladaptive cardiac phenotype seen in diabetic hearts. Given the pleiotropic effects of resistin, strategies targeting the control of resistin levels may constitute a potentially viable therapeutic utility in patients with diabetes and diabetes-induced cardiovascular diseases. Keywords: Diabetic cardiomyopathy; resistin; heart failure (HF); resistin therapy; fibrosis marker; diabetes Submitted Apr 28, 2015. Accepted for publication Apr 30, 2015. Diabetic cardiomyopathy: pathology and causes Obesity, insulin resistance and their frequent complication of type 2 diabetes mellitus (T2DM) are major risk factors of cardiac dysfunction and heart failure (HF). The epidemic rise, in particular of T2DM, is alarming, especially considering the increased incidence of insulin res Continue reading >>

Ebscohost | 74751773 | A New Insight Of Mechanisms, Diagnosis And Treatment Of Diabetic Cardiomyopathy.

Ebscohost | 74751773 | A New Insight Of Mechanisms, Diagnosis And Treatment Of Diabetic Cardiomyopathy.

A new insight of mechanisms, diagnosis and treatment of diabetic cardiomyopathy. Source: Endocrine (1355008X) . Jun2012, Vol. 41 Issue 3, p398-409. 12p. Abstract: Diabetes mellitus is one of the most common chronic diseases across the world. Cardiovascular complication is the major morbidity and mortality among the diabetic patients. Diabetic cardiomyopathy, a new entity independent of coronary artery disease or hypertension, has been increasingly recognized by clinicians and epidemiologists. Cardiac dysfunction is the major characteristic of diabetic cardiomyopathy. For a better understanding of diabetic cardiomyopathy and necessary treatment strategy, several pathological mechanisms such as impaired calcium handling and increased oxidative stress, have been proposed through clinical and experimental observations. In this review, we will discuss the development of cardiac dysfunction, the mechanisms underlying diabetic cardiomyopathy, diagnostic methods, and treatment options. Copyright of Endocrine (1355008X) is the property of Springer Science & Business Media B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. For access to this entire article and additional high quality information, please check with your college/university library, local public library, or affiliated institution. Important User Information: Remote access to EBSCO's databases is permitted to patrons of subscribing institutions accessing from remote locati Continue reading >>

Diabetic Cardiomyopathy: Current Approach And Potential Diagnostic And Therapeutic Targets

Diabetic Cardiomyopathy: Current Approach And Potential Diagnostic And Therapeutic Targets

Diabetic Cardiomyopathy: Current Approach and Potential Diagnostic and Therapeutic Targets Georgiana-Emmanuela Gilca ,1 Gabriela Stefanescu ,2 Oana Badulescu ,1 Daniela-Maria Tanase ,3 Iris Bararu ,1and Manuela Ciocoiu 1 1Department of Pathophysiology, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa Iasi, Iasi, Romania 2Gastroenterology Department, Sf. Spiridon County Clinical Emergency Hospital, University of Medicine and Pharmacy Grigore T. Popa Iasi, Iasi, Romania 33rd Internal Medicine Clinic, Sf. Spiridon County Clinical Emergency Hospital, University of Medicine and Pharmacy Grigore T. Popa Iasi, Iasi, Romania Correspondence should be addressed to Manuela Ciocoiu ; [email protected] Received 29 December 2016; Revised 2 March 2017; Accepted 9 March 2017; Published 21 March 2017 Copyright 2017 Georgiana-Emmanuela Gilca et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Although ischemic heart disease is the major cause of death in diabetic patients, diabetic cardiomyopathy (DCM) is increasingly recognized as a clinically relevant entity. Considering that it comprises a variety of mechanisms and effects on cardiac function, increasing the risk of heart failure and worsening the prognosis of this patient category, DCM represents an important complication of diabetes mellitus, with a silent development in its earlier stages, involving intricate pathophysiological mechanisms, including oxidative stress, defective calcium handling, altered mitochondrial function, remodeling of the extracellular matrix, and consequent deficient cardiomyocyte contractility. While DCM is com Continue reading >>

Insulin Resistance And Hyperinsulinaemia In Diabetic Cardiomyopathy

Insulin Resistance And Hyperinsulinaemia In Diabetic Cardiomyopathy

Insulin resistance and hyperinsulinaemia in diabetic cardiomyopathy Guanghong Jia is an Assistant Research Professor in the Diabetes and Cardiovascular Center within the Department of Internal Medicine at the University of Missouri, Missouri, USA. Dr Jia obtained his PhD in Medicine at the Huazhong University of Science and Technology, Hubei, China, in 2002. His current research focuses on insulin signalling in cardiovascular function in obesity and type 2 diabetes mellitus. Vincent G. DeMarco is an Associate Research Professor in the Diabetes and Cardiovascular Center within the Department of Internal Medicine at the University of Missouri, Missouri, USA. Dr DeMarco obtained his PhD in Zoology at the University of Florida, Florida, USA, in 1991. He examined the efficacy of inhaled nitric oxide in an ovine model of pulmonary arterial hypertension while on an American Heart Association Postdoctoral Fellowship in the Department of Physiology in the School of Medicine at the University of Florida. His current research focuses on the therapeutic targeting of metabolic, structural and functional complications of obesity, diabetes mellitus and hypertension in the heart and vasculature. James R. Sowers received his MD at the University of Missouri, Missouri, USA, in 1971 and conducted his fellowship training at University of California Los Angeles, California, USA. He is Professor of Medicine and Division Chief of Endocrinology. Dr Sowers' research focuses on cellular mechanisms of insulin action in cardiovascular, renal and skeletal muscle tissue and utilizes molecular and translational methods to examine the impact of the reninangiotensinaldosterone system, overnutrition and oxidative stress on tissue insulin metabolic signalling. Dr Sowers is Principle Investigator on one Continue reading >>

Second In A Series On Diabetes And The Heart: Diabetic Cardiomyopathy - Mechanisms And Mode Of Diagnosis

Second In A Series On Diabetes And The Heart: Diabetic Cardiomyopathy - Mechanisms And Mode Of Diagnosis

SPECT - Stress single-photon emission computed tomography Although it is perceived to be a complicated terminology, the concept of diabetic cardiomyopathy (DCM) was introduced long ago and has subsequently been widely reported and used by epidemiologists and clinicians across the globe. Diabetic cardiomyopathy refers to diabetes-associated structural and functional myocardial dysfunction not related to other confounding traditional factors such as coronary artery disease (CAD), hypertension, congenital heart diseases or valvular heart diseases [ 1-3 ]. Several postulated pathological mechanisms have been described and implicated in the pathogenesis of DCM in diabetic patients. The mechanistic changes in ventricular myocardial structure, calcium signaling mechanistic pathways and metabolism are some early defects reported in animal models; which may precede clinical manifestations of cardiac dysfunction in humans with DCM. Although transthoracic echocardiography (TTE) is regarded as a gold standard non-invasive imaging modality to evaluate ventricular myocardial dysfunction in the current era, DCM presents with subtle functional changes early in the course of the diseases process which may be difficult to detect with conventional TTE; however, these early changes can be detected if specifically looked for. To date, the concept of diabetic cardiomyopathy remains controversial. As a result, no specific treatment strategies have been established to treat or prevent myocardial dysfunction in diabetes mellitus (DM). We opted to review the literature on ventricular myocardial dysfunction in DM. In particular, we shall review the basic pathogenic mechanisms and diagnosis of diabetic cardiomyopathy. Pathological mechanism of diabetic cardiomyopathy Diabetic cardiomyopathy has b Continue reading >>

Role Of Micrornas In The Pathogenesis Of Diabetic Cardiomyopathy (review)

Role Of Micrornas In The Pathogenesis Of Diabetic Cardiomyopathy (review)

Role of microRNAs in the pathogenesis of diabetic cardiomyopathy (Review) Affiliations: Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, P.R. China, Emergency Department, Rizhao Chinese Medicine Hospital, Rizhao, Shandong 276800, P.R. China Published online on: January 12, 2017 Metrics: HTML 0 views | PDF 0 views Cited By (CrossRef): 0 citations The morbidity of diabetes mellitus has been increasing annually. As a progressive metabolic disorder, chronic complications occur in the late stage of diabetes. In addition, cardiovascular diseases account for the major cause of morbidity and mortality among the diabetic population worldwide. Diabetic cardiomyopathy (DCM) is a type of diabetic heart disease. Patients with DCM show symptoms and signs of heart failure while no specific cause, such as coronary disease, hypertension, alcohol consumption, or other structural heart diseases has been identified. The pathogenesis of DCM is complex and has not been well understood until recently. MicroRNAs (miRs) belong to a novel family of highly conserved, short, noncoding, singlestranded RNA molecules that regulate transcriptional and posttranscriptional gene expression. Furthermore, recent studies have demonstrated an association between miRs and DCM. In the current review, the role of miRs in the pathogenesis of DCM is summarized. It was concluded that miRs contribute to the regulation of cardiomyocyte hypertrophy, myocardial fibrosis, cardiomyocyte apoptosis, mitochondrial dysfunction, myocardial electrical remodeling, epigenetic modification and various other pathophysiological processes of DCM. These studies may provide novel insights into targets for preve Continue reading >>

:: The Korean Journal Of Internal Medicine

:: The Korean Journal Of Internal Medicine

Keywords: Diabetic cardiomyopathies ; Heart failure ; Diabetes mellitus The cardiovascular disease-related mortality with diabetes mellitus is ~65%. Therefore, diabetes mellitus is regarded as a risk equivalent to coronary heart disease [ 1 ]. Diabetic heart disease is a growing and important public health risk [ 2 ]. It affects the heart in three ways: cardiac autonomic neuropathy (CAN), coronary artery disease (CAD) due to accelerated atherosclerosis, and diabetic cardiomyopathy (DCM) [ 1 ]. DCM is characterized by lipid accumulation in cardiomyocytes, fetal gene reactivation, and left ventricular (LV) hypertrophy, which together result in contractile dysfunction [ 2 ]. In 1881, Leyden first reported that DCM is a typical complication of diabetes mellitus. In 1888, Mayer asserted that diabetes mellitus is a metabolic disorder that can induce heart disease. Finally, the term diabetic cardiomyopathy was proposed by Rubler in 1972 after postmortem studies in diabetic patients with heart failure in whom coronary disease and other structural heart diseases, hypertension, and alcohol had been ruled out as possible causes [ 3 ]. A milestone study in 2002 by Finck and colleagues [ 4 ] cast light on the transcriptional mechanisms of DCM. These researchers suggested that the transcription factor, peroxisome proliferator-activated receptor (PPAR)-, along with its transcriptional targets, is upregulated in the hearts of mouse models of diabetes mellitus [ 2 , 4 ]. Currently, DCM is defined as myocardial dysfunction (MD) in patients with diabetes mellitus in the absence of hypertension and structural heart diseases such as valvular heart disease or CAD [ 5 ]. Diabetes mellitus is a well-known risk factor for the development of heart failure. The Framingham Heart Study demonstrate Continue reading >>

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An Error Occurred Setting Your User Cookie This site uses cookies to improve performance. If your browser does not accept cookies, you cannot view this site. There are many reasons why a cookie could not be set correctly. Below are the most common reasons: You have cookies disabled in your browser. You need to reset your browser to accept cookies or to ask you if you want to accept cookies. Your browser asks you whether you want to accept cookies and you declined. To accept cookies from this site, use the Back button and accept the cookie. Your browser does not support cookies. Try a different browser if you suspect this. The date on your computer is in the past. If your computer's clock shows a date before 1 Jan 1970, the browser will automatically forget the cookie. To fix this, set the correct time and date on your computer. You have installed an application that monitors or blocks cookies from being set. You must disable the application while logging in or check with your system administrator. This site uses cookies to improve performance by remembering that you are logged in when you go from page to page. To provide access without cookies would require the site to create a new session for every page you visit, which slows the system down to an unacceptable level. This site stores nothing other than an automatically generated session ID in the cookie; no other information is captured. In general, only the information that you provide, or the choices you make while visiting a web site, can be stored in a cookie. For example, the site cannot determine your email name unless you choose to type it. Allowing a website to create a cookie does not give that or any other site access to the rest of your computer, and only the site that created the cookie can read it. Continue reading >>

Frontiers | New Molecular Insights Of Insulin In Diabetic Cardiomyopathy | Physiology

Frontiers | New Molecular Insights Of Insulin In Diabetic Cardiomyopathy | Physiology

Front. Physiol., 12 April 2016 | New Molecular Insights of Insulin in Diabetic Cardiomyopathy 1Faculty of Chemical and Pharmaceutical Sciences and Faculty of Medicine, Advanced Center for Chronic Diseases, University of Chile, Santiago, Chile 2Faculty of Medicine, Advanced Center for Chronic Diseases, Pontifical Catholic University of Chile, Santiago, Chile 3Division of Cardiovascular Diseases, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile 4Department of Internal Medicine (Division of Cardiology), University of Texas Southwestern Medical Center, Dallas, TX, USA Type 2 diabetes mellitus (T2DM) is a highly prevalent disease worldwide. Cardiovascular disorders generated as a consequence of T2DM are a major cause of death related to this disease. Diabetic cardiomyopathy (DCM) is characterized by the morphological, functional and metabolic changes in the heart produced as a complication of T2DM. This cardiac disorder is characterized by constant high blood glucose and lipids levels which eventually generate oxidative stress, defective calcium handling, altered mitochondrial function, inflammation and fibrosis. In this context, insulin is of paramount importance for cardiac contractility, growth and metabolism and therefore, an impaired insulin signaling plays a critical role in the DCM development. However, the exact pathophysiological mechanisms leading to DCM are still a matter of study. Despite the numerous questions raised in the study of DCM, there have also been important findings, such as the role of micro-RNAs (miRNAs), which can not only have the potential of being important biomarkers, but also therapeutic targets. Furthermore, exosomes also arise as an interesting variable to consider, since they represent an important inter-cellul Continue reading >>

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