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Metabolic Alterations in Diabetic Cardiomyopathy

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Diabetic Cardiomyopathy

Part of the book series: Advances in Biochemistry in Health and Disease ((ABHD,volume 9))

Abstract

Diabetes mellitus causes cardiomyopathy in diabetic patients and is an important and dominant risk factor for congestive heart failure. With the growing prevalence of diabetes in Canada and throughout the world, diabetic cardiomyopathy is a significant public health issue. Diabetic cardiomyopathy has been defined as myocardial dysfunction that occurs in a diabetic milieu independent of identified causes such as coronary atherosclerosis, hypertension, or valvular heart disease. Alterations in ventricular structure as well as left ventricular systolic and diastolic dysfunctions have been reported in diabetic patients despite well-controlled glycemic levels and disease free coronary vasculature. Metabolic abnormalities such as hyperlipidemia, hyperinsulinemia, and hyperglycemia predispose the heart to cellular, structural, and functional alterations that manifest as the cardiac phenotype observed in this diabetic population. These mechanisms are likely to act synergistically and are believed to potentiate one another. Hyperglycemia is an essential factor in the development of cardiomyopathy and exerts its effects by altering protein kinase C, increasing oxidative stress and causing abnormalities in lipid metabolism and calcium ion homeostasis. Regardless of the extensive information available on diabetic cardiomyopathy, translational research is scarce due to the lack of clinical trials, and therefore, much of our current knowledge is extrapolated from animal models. This review focuses on illustrating the various metabolic alterations that contribute to the development and progression of diabetic cardiomyopathy.

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Acknowledgments

 The infrastructure for the work in this article was provided by the St. Boniface Hospital Research Foundation.

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Authors and Affiliations

  1. Departments of Internal Medicine and Physiology, Faculty of Medicine, Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, University of Manitoba, Winnipeg, MB, Canada

    Kimberly-Ann M. Bordun

  2. Departments of Internal Medicine and Physiology, Faculty of Medicine, Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, University of Manitoba, Rm Y3531, Bergen Cardiac Care Centre, St. Boniface General Hospital, 409 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada

    Davinder S. Jassal M.D., FACC, FRCPC

  3. Institute of Cardiovascular Sciences, St. Boniface Hospital Research, University of Manitoba, 351 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada

    Naranjan S. Dhalla Ph.D.

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  1. Kimberly-Ann M. Bordun
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  2. Davinder S. Jassal M.D., FACC, FRCPC
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  3. Naranjan S. Dhalla Ph.D.
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Correspondence to Davinder S. Jassal M.D., FACC, FRCPC .

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Editors and Affiliations

  1. Department of Biophysics, University of Ankara, Ankara, Ankara, Turkey

    Belma Turan

  2. St. Boniface Hosp. Research, Univ. of Ma Institute of Cardiovascular Sciences, Winnipeg, Manitoba, Canada

    Naranjan S. Dhalla

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Bordun, KA.M., Jassal, D.S., Dhalla, N.S. (2014). Metabolic Alterations in Diabetic Cardiomyopathy. In: Turan, B., Dhalla, N. (eds) Diabetic Cardiomyopathy. Advances in Biochemistry in Health and Disease, vol 9. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9317-4_1

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