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Current Diabetes Reports

, Volume 9, Issue 1, pp 79–86 | Cite as

The failing diabetic heart: Focus on diastolic left ventricular dysfunction

  • Loek van Heerebeek
  • Aernout Somsen
  • Walter J. Paulus
Article

Abstract

Diabetes mellitus (DM) is highly prevalent and is an important risk factor for congestive heart failure (HF). Increased left ventricular (LV) diastolic stiffness is recognized as the earliest manifestation of DM-induced LV dysfunction, but its pathophysiology remains incompletely understood. Mechanisms whereby DM increases LV diastolic stiffness differ between HF with normal LV ejection fraction (EF) (HFNEF) and HF with reduced LVEF (HFREF). In diabetic HFREF, fibrosis and deposition of advanced glycation end products (AGEs) are the most important contributors to high LV diastolic stiffness, whereas in diabetic HFNEF, elevated resting tension of hypertrophied cardiomyocytes is the most important contributor to high LV diastolic stiffness. As HF mortality remains high in DM despite proven efficacy of current treatments, better understanding of the pathophysiology of high LV diastolic stiffness could be beneficial for novel therapeutic strategies.

Keywords

Diabetic Cardiomyopathy Nesiritide Diabetic Heart Diastolic Heart Failure High Left Ventricular 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Current Medicine Group LLC 2009

Authors and Affiliations

  • Loek van Heerebeek
  • Aernout Somsen
  • Walter J. Paulus
    • 1
  1. 1.Laboratory of PhysiologyVU University Medical CenterAmsterdamThe Netherlands

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