Diabetes
Awanish Kumar, Ashwini Kumar in Diabetes, 2020
The Madras Diabetes Research Foundation (India) and Indian Diabetes Research Foundation (India) independently conducted various studies in India and concluded that Indians, especially the south Indian population, are at high risk of developing diabetes, insulin resistance and related cardiovascular complications. The primary risk factors observed in these studies, involving wide age group subjects, were low level of high-density lipoprotein (low HDL) and high triglyceride (TG) level, contributing to an increased risk of metabolic syndrome [21–23]. Diabetic cardiomyopathy can be defined as myocardial dysfunction in diabetic patients in the absence of coronary artery disease (CAD), hypertension and valve defects. The development of diabetic cardiomyopathy is attributed to various factors viz. insulin resistance, hyperlipidaemia and cardiac autonomic dysfunction. Insulin resistance and hyperlipidaemia are two major ingredients of a collective complication known as metabolic syndrome (MS). Hyperglycaemia, hyperinsulinaemia and elevated free fatty acid (FFA) are the major factors that lead to cardiac steatosis. Brain natriuretic peptide (BNP), biomolecule released from cardiac ventricles, was also found to be elevated in patients who suffered heart failure. The gene expression of BNP was also found to be upregulated in animal models of insulin resistance (hyperinsulinaemia) along with other symptoms such as LVH [24].
Congestive Heart Failure
Jahangir Moini, Matthew Adams, Anthony LoGalbo in Complications of Diabetes Mellitus, 2022
A cardiomyopathy is a primary myocardial disorder. It is different than structural cardiac disorders, including congenital heart disorders, coronary artery disease, or valvular disorders. There are three main types of cardiomyopathies which include dilated, hypertrophic, and restrictive cardiomyopathies. Dilated cardiomyopathy is myocardial dysfunction that results in HF, with ventricular dilation and systolic dysfunction. Hypertrophic cardiomyopathy is a congenital or acquired disorder, with extreme ventricular hypertrophy and diastolic dysfunction, lacking increased afterload – it may be caused by coarctation of the aorta, systemic hypertension, or valvular aortic stenosis. Restrictive cardiomyopathy involves noncompliant ventricular walls, which resist diastolic filling. When one ventricle is affected it is usually the LV. However, both ventricles can be affected. An ischemic cardiomyopathy can occur with severe CAD, with or without infarction. It is not a primary myocardial disorder. Cardiomyopathies are signified by signs and symptoms of HF, based on systolic, diastolic, or combined dysfunction. Diabetic cardiomyopathy is cardiac dysfunction with structural, functional, and metabolic alterations even though coronary artery disease may be absent.
Complications of Diabetes and Role of a Citrus Flavonoid Nobiletin in its Treatment
Vikas Kumar, Addepalli Veeranjaneyulu in Herbs for Diabetes and Neurological Disease Management, 2018
Diabetic cardiac autonomic neuropathy is also seen in most of the patients and is frequently under diagnosed. Typical clinical symptoms include resting tachycardia, exercise intolerance, HR (heart rate) variability and slow recovery after exercise, and increased mortality rate along with silent myocardial infarction.48 The prevalence of diabetes-related cardiac autonomic neuropathy is unclear and has been reported to range from 1 to 90%, depending on the outcome variable.49 Risk factors for diabetes-associated cardiac neuropathy include age, obesity, smoking, poor glycemic control, and hypertension.50 Patients with diabetic cardiomyopathy show typically abnormal diastolic filling and relaxation accompanied by systolic dysfunction that with time may lead to heart failure. Many of the stated mechanisms and risk factors for diabetic cardiomyopathy and cardiac autonomic dysfunction are very similar and thus it is unclear if cardiac autonomic dysfunction directly mediates diabetic cardiomyopathy.51
Liraglutide reduces hyperglycemia-induced cardiomyocyte death through activating glucagon-like peptide 1 receptor and targeting AMPK pathway
Published in Journal of Receptors and Signal Transduction, 2020
Guanqun Ma, Yingwu Liu, Yu Wang, Zhinan Wen, Xin Li, Hu Zhai, Li Miao, Jieying Luo
Diabetic cardiomyopathy is a major complication of DM and usually leads to heart failure. Numerous researches focused on its pathogenesis in order to find out the effective treatment. Although several anti-diabetes drugs have been developed [53,64], the cardioprotective effects of these anti-diabetes remain clear. In this study, we explored the molecular mechanism underlying liraglutide on hyperglycemia-treated cardiomyocytes, with a focus on its anti-inflammatory action and anti-oxidative stress property [65,66]. We found that liraglutide could reverse cell viability in cardiomyocyte and this effect was highly dependent on its ROS-reducing and inflammation-suppressing effects [67,68]. Further, we also reported that liraglutide treatment could improve the activity of AMPK and thus enhance the expression of glucagon-like peptide 1 receptor [69,70]. Interestingly, inhibition of AMPK pathway could abolish the beneficial effects exerted by liraglutide on hyperglycemia-treated cardiomyocytes.
The multifaceted role of cytochrome P450-Derived arachidonic acid metabolites in diabetes and diabetic cardiomyopathy
Published in Drug Metabolism Reviews, 2022
Fadumo Ahmed Isse, Ahmed A. El-Sherbeni, Ayman O. S. El-Kadi
The incidence rates of diabetes are increasing in Canada and worldwide as obesity rates continue to increase and remain to be the major cause of insulin resistance in our generation. Diabetes adversely affects the cardiac function by activating different deleterious pathways that lead to cardiac injury and cardiac remodeling. P450 and LOX-derived metabolites directly play a significant role in the pathogenesis of diabetes and diabetic cardiomyopathy. P450-derived EETs protect against diabetes and diabetic cardiomyopathy. Development of new agents or advancing currently existing agents that target these pathways could lead to potential therapeutic benefits in treating diabetes and diabetic cardiomyopathy. As discussed in the different sections of this review, there is growing evidence in the literature indicating the effectiveness of sEH inhibition and maintaining levels of EETs in improving glucose abnormalities. sEH inhibitors investigated in diabetic animal models caused significant improvement in both IDD and NIDD. In addition, we presented substantial evidence of the role of 20-HETE inhibition in various disease and the remarkable effect of this inhibition on restoring glucose metabolism abnormalities in animal models. Moreover, we reported the involvement of 12-HETE from 12/15-LOX pathways in diabetes and diabetic cardiomyopathy. In conclusion, this review highlighted the involvement of AA metabolism in diabetes and diabetic cardiomyopathy.
Restorative Effect of Semecarpus Anacardium on Altered Energy Metabolism in Type-2 Diabetes Mellitus–Induced Cardiac Dysfunction in Rats
Published in Journal of Dietary Supplements, 2020
Suganthi Subramani, Haseena Banu Hedyathullah Khan, Shanthi Palanivelu, Sachidanandam Thiruvaiyaru Panchanadham
Reduction of glucose metabolism is believed to be an important mechanism in diabetic cardiomyopathy (Belke et al. 2000), and restoration of cardiac glucose metabolism improves diabetic heart function. Defective glycolysis in the heart of diabetic patients and in experimental diabetic animal models has been reported (Rodrigues and McNeill 1992). In type 2 diabetes mellitus (T2DM), hyperglycemia results from both lack of suppression of hepatic glucose production in the absorptive state and excessive glucose production in the postabsorptive state. Significant decreases in the activities of glycolytic enzymes hexokinase, phosphoglucoisomerase, and aldolase were observed in CVD-induced diabetic rats consistent with those of other studies (Radhika and Krishnakumari Sudarsanam 2010).
Related Knowledge Centers
- Coronary Artery Disease
- Diabetes
- Peripheral Edema
- Hypertension
- Lung
- Pulmonary Edema
- Cardiac Muscle
- Heart Failure
- Leg
- Compliance