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Pathogenesis, Clinical Features and Treatment of Diabetic Cardiomyopathy

  • Núria Alonso
  • Pedro Moliner
  • Dídac Mauricio
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1067)

Abstract

Patients with type 1 and type 2 diabetes mellitus (T1D and T2D) show an increased incidence of heart failure (HF) even after adjustment for well established risk factors for HF such as hypertension and ischaemic heart disease. The resulting specific form of cardiomyopathy is known as diabetic cardiomyopathy” (DCM). Pathogenetic mechanisms underlying DCM are likely to be multifactorial, from altered myocardial metabolism (hyperglycaemia, hyperinsulinaemia, increased circulating fatty acids and trglycerides) to microvascular disease, autonomic neuropathy, and altered myocardial structure with fibrosis. Current medical treatment recommendations from scientific societies on HF in patients with diabetes mellitus (DM) do not differ from those for patients without DM. Regarding the effect of different hypoglycaemic drugs on HF in patients with DM, and considering the best available current evidence, the sodium-glucose-co-transporter 2 inhibitors and metformin seem to be especially advantageous regarding the effects in patients with T2D and HF.

Keywords

Heart failure Diabetes mellitus Diabetic cardiomyopathy Cardiac lipotoxicity Left ventricular ejection fraction Diastolic dysfunction Systolic dysfunction 

Notes

Acknowledgments

This work wfrom Instituto de Salud Carlos III, Ministry of Economy and Competitiveness, Spain; CIBERDEM, a research network initiative of Instituto de Salud Carlos III, Spain and from la Fundació Marató TV3 (Grant number 201602.30.31) of Spain.

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Núria Alonso
    • 1
    • 2
    • 3
    • 5
  • Pedro Moliner
    • 4
    • 5
  • Dídac Mauricio
    • 1
    • 2
    • 3
    • 5
  1. 1.Department of Endocrinology and Nutrition ServiceUniversity Hospital Germans Trias i PujolBadalonaSpain
  2. 2.Centro de Investigación Biomédica Sobre Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIIIMadridSpain
  3. 3.Institut de Recerca Biomèdica de LleidaLleidaSpain
  4. 4.BadalonaSpain
  5. 5.Department of MedicineBarcelona Autonomous University (UAB)BarcelonaSpain

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