, Volume 7, Issue 6, pp 490-494
Date: 09 Oct 2013

Diabetic Cardiomyopathy in the Elderly

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Diabetic cardiomyopathy is a microvascular disorder that occurs in diabetics that may lead to congestive heart failure (CHF) in the absence of hypertension, coronary artery disease, or valvular heart disease. In a large study of elderly subjects with 865 men and 1872 women, mean age 81 ± 9 years, CHF developed in 272 of 690 diabetics (39 %) and in 467 of 2047 nondiabetics (23 %) (P < 0.0001) at 43-month follow-up. Cox regression analysis showed that diabetes mellitus (risk ratio = 1.34, P = 0.0003) was an independent significant predictor of time to development of CHF. For each 1 % increase in hemoglobin A1c, in 25,958 men and 22,900 women with diabetes, there was an 8 % increased risk of CHF (95 % CI, 5 %–12 %). The pathologic substrate of diabetic cardiomyopathy is characterized by myocardial damage, left ventricular hypertrophy, interstitial fibrosis, structural and functional changes of the coronary vessels, metabolic abnormalities, and autonomic cardiac neuropathy.