Diabetic Cardiomyopathy: An Update on Its Pathophysiology With Specific Emphasis on Epigenetics Modifications Besides Treatment – A Systematic Review

Abstract

Diabetes mellitus (DM) represents a significant lifestyle disease. Of the types of DM, type 2 DM aids maximuminthedevelopmentofcardiovasculardisease(CVD)alongwithdiabeticcardiomyopathy(DbCM),which iscorrelatedwithsignificantmortalityalongwithcomorbidityindiabeticpatients.DbCMisanon-canonicalcardiac illness that exhibits cardiac remodelling occurs when there is DM but not when there is any concomitant conditions like hypertension, valve disease, or coronary artery disease (CAD). DbCM is linked to altered mitochondrial structure and function, as well as aberrant cardiac metabolism. Additional physiological and pathological signaling mechanisms include inflammation, oxidative stress (OS), and others; besides, in the diabetic environment, there are various cardiomyopathy-inducing factors such as reactive oxygen species (ROS)-modulated OS, hyperglycemic situations, cytokines-modulated These mediators induce inflammatory responses, cell death, including apoptosis, pyroptosis,andautophagy,aswellastheepigeneticcontrolofabnormalmolecularpathways.Thelasttenyearshave demonstrated the importance of miRNAs and long noncoding RNAs (lncRNAs) in controlling key biological processessuchcelldeath,mitochondrialdysfunction,andelectricalremodelling.Cardiomyopathyisasignificantevent regardingcardiacremodelingeventinDbCM.Considerableproofexistsregardingthepartofepigeneticsindiabetic correlated cell demise. Epigenetic controlling modes like histone alterations, DNA methylation, and miRNA along with lncRNAs control cardiac cell demise in the diabetic environment. Akin to that, other modes such as mitochondrialimpairmentandOSarecontrolledbymiRNAalongwithlncRNAs.Findingthesemodeshasgivenprovisionof generationofinnovativetherapyapproachesforDbCM.miRNAsalongwithlncRNAshaveillustratedtranslational capacity in the form of Besides treatment options, There are other DbCM-specific diagnostic and prognostic biomarkers available. HDACs were further shown to have a crucial role in controlling the pathogenesis of DbCM.