Diagnostic approaches for diabetic cardiomyopathy and myocardial fibrosis

Abstract

In diabetes mellitus, alterations in cardiac structure/function in the absence of ischemic heart disease, hypertension or other cardiac pathologies is termed diabetic cardiomyopathy. In the United States, the prevalence of diabetes mellitus continues to rise and the disease currently affects about 8% of the general population. Hence, it is imperative the use of appropriate diagnostic strategies for diabetic cardiomyopathy, which may help correctly identify the disease at early stages and implement suitable corrective therapies. Currently, there is no single diagnostic method for the identification of diabetic cardiomyopathy. Diabetic cardiomyopathy is known to induce changes in cardiac structure such as, myocardial hypertrophy, fibrosis and fat droplet deposition. Early changes in cardiac function are typically manifested as abnormal diastolic function that with time leads to loss of contractile function. Echocardiography based methods currently stands as the preferred diagnostic approach for diabetic cardiomyopathy, due to its wide availability and economical use. In addition to conventional techniques, magnetic resonance imaging and spectroscopy along with contrast agents are now leading new approaches in the diagnosis of myocardial fibrosis, and cardiac and hepatic metabolic changes. These strategies can be complemented with serum biomarkers so they can offer a clear picture as to diabetes-induced changes in cardiac structure/function even at very early stages of the disease. This review article intends to provide a summary of experimental and routine tools currently available to diagnose diabetic cardiomyopathy induced changes in cardiac structure/function. These tools can be reliably used in either experimental models of diabetes or for clinical applications.

Dynamic Changes in Myocardial Matrix and Relevance to Disease

“…The amino-terminal propeptide of procollagen type III has been reported to rise with insulin resistance in normotensive, nondiabetic obese subjects and may be predictive of early LV dysfunction. 41,42 Support for this concept comes from a recent report by Lopez-Andrès et al, 43 which showed a positive correlation between serum propeptide of procollagen type III and adverse cardiovascular outcomes in subjects with heart failure from the Cardiac Resynchronization in Heart Failure (CARE-HF) trial. Thus, circulating propeptide of procollagen type III might have diagnostic and predictive value as a biomarker of heart failure disease status.…”

In-silico screening of Alpha Amylase Enzyme Inhibitors from Siddha Formulation Pungampoo Chooranam by Molecular docking analysis for the management of Type II Diabetes mellitus

“…Diabetes is multifactorial and has been associated with various disorders including obesity, dyslipidemia, thrombosis, infarction, hypertension, endothelial dysfunction, and coronary artery disease [25]. However, diastolic and systolic dysfunctions are mainly altered apart from traditional cardiac risks parameters such as hypertension, atherosclerosis, and dyslipidemia [26].…”

Diabetic cardiomyopathy

“…The most frequently used diagnostic methods are echocardiography and cardiac magnetic resonance imaging (MRI) (8,9). In the early phase of DCP, the pathologic changes can be reversible with strict metabolic control, but in the continuous process the myocardial changes become irreversible and the risk of developing HF increases (10)(11)(12). This review focuses on pathophysiology, diagnosis and management of DCP.…”