Diastolic Dysfunction in Patients with Non-insulin-dependent Diabetes Mellitus of Short Duration

Bonito, Procolo Di; Cuomo, Sergio; Moio, Nicola; Sibilio, Girolamo; Sabatini, D; Quattrin, S.; Capaldo, Brunella

doi:10.1002/(sici)1096-9136(199604)13:4<321::aid-dia3>3.0.co;2-7

Cited by 104 publications

(29 citation statements)

References 12 publications

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“…Later, this evidence was confirmed in large epidemiologic studies [102]. The term now includes diabetic individuals with diastolic dysfunction, with a prevalence as high as 60% in well-controlled type 2 diabetic patients [19,51,52,145,175]. However, the concept as a clinical entity remains vague, despite more than 35 years of basic and clinical investigations.…”

Section: Introduction and Definition Of Diabetic Cardiomyopathymentioning

confidence: 91%

Diabetic cardiomyopathy: understanding the molecular and cellular basis to progress in diagnosis and treatment

2011

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Diabetes mellitus is an important and prevalent risk factor for congestive heart failure. Diabetic cardiomyopathy has been defined as ventricular dysfunction that occurs in diabetic patients independent of a recognized cause such as coronary artery disease or hypertension. The disease course consists of a hidden subclinical period, during which cellular structural insults and abnormalities lead initially to diastolic dysfunction, later to systolic dysfunction, and eventually to heart failure. Left ventricular hypertrophy, metabolic abnormalities, extracellular matrix changes, small vessel disease, cardiac autonomic neuropathy, insulin resistance, oxidative stress, and apoptosis are the most important contributors to diabetic cardiomyopathy onset and progression. Hyperglycemia is a major etiological factor in the development of diabetic cardiomyopathy. It increases the levels of free fatty acids and growth factors and causes abnormalities in substrate supply and utilization, calcium homeostasis, and lipid metabolism. Furthermore, it promotes excessive production and release of reactive oxygen species, which induces oxidative stress leading to abnormal gene expression, faulty signal transduction, and cardiomyocytes apoptosis. Stimulation of connective tissue growth factor, fibrosis, and the formation of advanced glycation end-products increase the stiffness of the diabetic hearts. Despite all the current information on diabetic cardiomyopathy, translational research is still scarce due to limited human myocardial tissue and most of our knowledge is extrapolated from animals. This paper aims to elucidate some of the molecular and cellular pathophysiologic mechanisms, structural changes, and therapeutic strategies that may help struggle against diabetic cardiomyopathy.

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Section: Introduction and Definition Of Diabetic Cardiomyopathymentioning

confidence: 91%

Diabetic cardiomyopathy: understanding the molecular and cellular basis to progress in diagnosis and treatment

2011

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“…These abnormalities are the result of factors such as myocardial ischemia, hypertrophy, reduced ß-adrenergic tone, and increased myocardial Left Ventricular Diastolic Function in the Elderly connective (or other matrix) tissue. LV diastolic dysfunction has been reported in patients with arterial hypertension, 6 ischemic heart disease, 7 myocarditis, 8 idiopathic hypertrophic cardiomyopathy, 9,10 amyloidosis, 11 sarcoidosis, 12 diabetes mellitus (both insulin-dependent 13 and non-insulindependent 14 ), and pericarditis. 15 LV diastolic dysfunction can occur prior to the development of gross LV structural abnormalities.…”

Section: Mechanisms Of LV Diastolic Dysfunction In the Elderlymentioning

confidence: 99%

Left Ventricular Diastolic Function in the Elderly

Tokushima

Reid

Gardin

2001

American J Geri Cardiology

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Previous studies using pulsed Doppler echocardiography have demonstrated a pattern of abnormal left ventricular relaxation associated with increasing age. Specifically, aging is associated with decreased peak velocity of early diastolic mitral inflow, increased peak velocity of late diastolic inflow, increased isovolumic relaxation time, and early diastolic deceleration time. Abnormal relaxation can progress to significantly elevated left atrial pressure--characterized by increased early peak velocity and shortened isovolumic relaxation time and deceleration time--as part of the disease processes. Left ventricular diastolic dysfunction is highly prevalent, occurring in one half to two thirds of elderly patients with congestive heart failure, in association with normal systolic function. Left ventricular hypertrophy, which is commonly related to systemic arterial hypertension, and ischemic heart disease are the two major causes of abnormal left ventricular diastolic function in the elderly. Recently, newer echocardiographic techniques have been described that allow more accurate evaluation of left ventricular diastolic function. Treatments for left ventricular diastolic dysfunction should focus on the underlying disease etiology as well as on the derangement in left ventricular diastolic function. Although calcium channel blockers and angiotensin-converting enzyme inhibitors have been used clinically to treat diastolic dysfunction, their effects on prognosis remain unproven.

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“…1 Heart failure has a worse prognosis in diabetic than in non-diabetic patients. 2 Evidence of diastolic dysfunction appears early in the natural history of type 2 diabetes mellitus 3 and evidence of impaired systolic function may subsequently become apparent. 4 Even a mild degree of diastolic dysfunction has prognostic impact.…”

Section: Introductionmentioning

confidence: 97%

Tissue Doppler imaging for the detection and quantitation of myocardial dysfunction in patients with type 2 diabetes mellitus

Bibra

Thráinsdóttir

Hansen

et al. 2005

Diabetes and Vascular Disease Research

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Diastolic Dysfunction in Patients with Non-insulin-dependent Diabetes Mellitus of Short Duration

Cited by 104 publications

References 12 publications

Diabetic cardiomyopathy: understanding the molecular and cellular basis to progress in diagnosis and treatment

Diabetic cardiomyopathy: understanding the molecular and cellular basis to progress in diagnosis and treatment

Left Ventricular Diastolic Function in the Elderly

Tissue Doppler imaging for the detection and quantitation of myocardial dysfunction in patients with type 2 diabetes mellitus

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