351
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Nirengi S, Peres Valgas da Silva C, Stanford KI. Disruption of energy utilization in diabetic cardiomyopathy; a mini review. Curr Opin Pharmacol 2020; 54:82-90. [PMID: 32980777 DOI: 10.1016/j.coph.2020.08.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 08/20/2020] [Accepted: 08/25/2020] [Indexed: 02/08/2023]
Abstract
Type 2 diabetes (T2D) substantially elevates the risk for heart failure, a major cause of death. In advanced T2D, energy metabolism in the heart is disrupted; glucose metabolism is decreased, fatty acid (FA) metabolism is enhanced to maintain ATP production, and cardiac function is impaired. This condition is termed diabetic cardiomyopathy (DCM). The exact cause of DCM is still unknown although altered metabolism is an important component. While type 2 diabetes is characterized by insulin resistance, the traditional antidiabetic agents that improve insulin stimulation or sensitivity only partially improve DCM-induced cardiac dysfunction. Recently, sodium-glucose transporter-2 (SGLT2) inhibitors have been identified as potential pharmacological agents to treat DCM. This review highlights the molecular mechanisms underlying cardiac energy metabolism in DCM, and the potential effects of SGLT2 inhibitors.
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Affiliation(s)
- Shinsuke Nirengi
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; Department of Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Carmem Peres Valgas da Silva
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; Department of Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Kristin I Stanford
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; Department of Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
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352
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Martinez-Amezcua P, Haque W, Khera R, Kanaya AM, Sattar N, Lam CSP, Harikrishnan S, Shah SJ, Kandula NR, Jose PO, Narayan KMV, Agyemang C, Misra A, Jenum AK, Bilal U, Nasir K, Cainzos-Achirica M. The Upcoming Epidemic of Heart Failure in South Asia. Circ Heart Fail 2020; 13:e007218. [PMID: 32962410 DOI: 10.1161/circheartfailure.120.007218] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Currently, South Asia accounts for a quarter of the world population, yet it already claims ≈60% of the global burden of heart disease. Besides the epidemics of type 2 diabetes mellitus and coronary heart disease already faced by South Asian countries, recent studies suggest that South Asians may also be at an increased risk of heart failure (HF), and that it presents at earlier ages than in most other racial/ethnic groups. Although a frequently underrecognized threat, an eventual HF epidemic in the densely populated South Asian nations could have dramatic health, social and economic consequences, and urgent interventions are needed to flatten the curve of HF in South Asia. In this review, we discuss recent studies portraying these trends, and describe the mechanisms that may explain an increased risk of premature HF in South Asians compared with other groups, with a special focus on highly relevant features in South Asian populations including premature coronary heart disease, early type 2 diabetes mellitus, ubiquitous abdominal obesity, exposure to the world's highest levels of air pollution, highly prevalent pretransition forms of HF such as rheumatic heart disease, and underdevelopment of healthcare systems. Other rising lifestyle-related risk factors such as use of tobacco products, hypertension, and general obesity are also discussed. We evaluate the prognosis of HF in South Asian countries and the implications of an anticipated HF epidemic. Finally, we discuss proposed interventions aimed at curbing these adverse trends, management approaches that can improve the prognosis of prevalent HF in South Asian countries, and research gaps in this important field.
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Affiliation(s)
- Pablo Martinez-Amezcua
- Johns Hopkins Bloomberg School of Public Health (P.M.-A., W.H.), Johns Hopkins University, Baltimore, MD
| | - Waqas Haque
- Johns Hopkins Bloomberg School of Public Health (P.M.-A., W.H.), Johns Hopkins University, Baltimore, MD.,Ciccarone Center for the Prevention of Cardiovascular Disease (W.H., K.N., M.C.-A.), Johns Hopkins University, Baltimore, MD
| | - Rohan Khera
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (R.K.).,Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT (R.K.)
| | | | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, United Kingdom (N.S.)
| | - Carolyn S P Lam
- National Heart Centre Singapore (C.S.P.L.).,Duke-National University of Singapore (C.S.P.L.).,University Medical Centre, Groningen, the Netherlands (C.S.P.L.)
| | - Sivadasanpillai Harikrishnan
- Heart Failure Association of India (S.H.).,National Center of Research and Excellence in Heart Failure, ICMR (S.H.).,Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum (S.H.)
| | - Sanjiv J Shah
- Bluhm Cardiovascular Institute and Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.)
| | - Namratha R Kandula
- Northwestern University, Feinberg School of Medicine, Chicago, IL (N.R.K.)
| | - Powell O Jose
- Sutter Davis Hospital, Sutter Medical Center, Sacramento, CA (P.O.J.)
| | - K M Venkat Narayan
- Rollins School of Public Health, Emory University and Emory University School of Medicine, Atlanta, GA (K.M.V.N.)
| | - Charles Agyemang
- Department of Public Health, Amsterdam UMC, University of Amsterdam, the Netherlands (C.A.)
| | - Anoop Misra
- Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, New Delhi, India (A.M.).,National Diabetes, Obesity and Cholesterol Foundation (N-DOC), New Delhi, India (A.M.).,Diabetes Foundation India, New Delhi, India (A.M.)
| | - Anne K Jenum
- General Practice Research Unit (AFE), Department of General Practice, University of Oslo, Institute of Health and Society, Norway (A.K.J.)
| | - Usama Bilal
- Urban Health Collaborative and Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, PA (U.B.)
| | - Khurram Nasir
- Ciccarone Center for the Prevention of Cardiovascular Disease (W.H., K.N., M.C.-A.), Johns Hopkins University, Baltimore, MD.,Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX (K.N., M.C.-A.).,Center for Outcomes Research, Houston Methodist, Houston, TX (K.N., M.C.-A.)
| | - Miguel Cainzos-Achirica
- Ciccarone Center for the Prevention of Cardiovascular Disease (W.H., K.N., M.C.-A.), Johns Hopkins University, Baltimore, MD.,Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX (K.N., M.C.-A.).,Center for Outcomes Research, Houston Methodist, Houston, TX (K.N., M.C.-A.)
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353
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AI-based prediction for the risk of coronary heart disease among patients with type 2 diabetes mellitus. Sci Rep 2020; 10:14457. [PMID: 32879331 PMCID: PMC7467935 DOI: 10.1038/s41598-020-71321-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 07/27/2020] [Indexed: 11/09/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is one common chronic disease caused by insulin secretion disorder that often leads to severe outcomes and even death due to complications, among which coronary heart disease (CHD) represents the most common and severe one. Given a huge number of T2DM patients, it is thus increasingly important to identify the ones with high risks of CHD complication but the quantitative method is still not available. Here, we first curated a dataset of 1,273 T2DM patients including 304 and 969 ones with or without CHD, respectively. We then trained an artificial intelligence (AI) model using randomly selected 4/5 of the dataset and use the rest data to validate the performance of the model. The result showed that the model achieved an AUC of 0.77 (fivefold cross-validation) on the training dataset and 0.80 on the testing dataset. To further confirm the performance of the presented model, we recruited 1,253 new T2DM patients as totally independent testing dataset including 200 and 1,053 ones with or without CHD. And the model achieved an AUC of 0.71. In addition, we implemented a model to quantitatively evaluate the risk contribution of each feature, which is thus able to present personalized guidance for specific individuals. Finally, an online web server for the model was built. This study presented an AI model to determine the risk of T2DM patients to develop to CHD, which has potential value in providing early warning personalized guidance of CHD risk for both T2DM patients and clinicians.
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354
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Jubaidi FF, Zainalabidin S, Mariappan V, Budin SB. Mitochondrial Dysfunction in Diabetic Cardiomyopathy: The Possible Therapeutic Roles of Phenolic Acids. Int J Mol Sci 2020; 21:ijms21176043. [PMID: 32842567 PMCID: PMC7503847 DOI: 10.3390/ijms21176043] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 08/08/2020] [Accepted: 08/11/2020] [Indexed: 12/20/2022] Open
Abstract
As the powerhouse of the cells, mitochondria play a very important role in ensuring that cells continue to function. Mitochondrial dysfunction is one of the main factors contributing to the development of cardiomyopathy in diabetes mellitus. In early development of diabetic cardiomyopathy (DCM), patients present with myocardial fibrosis, dysfunctional remodeling and diastolic dysfunction, which later develop into systolic dysfunction and eventually heart failure. Cardiac mitochondrial dysfunction has been implicated in the development and progression of DCM. Thus, it is important to develop novel therapeutics in order to prevent the progression of DCM, especially by targeting mitochondrial dysfunction. To date, a number of studies have reported the potential of phenolic acids in exerting the cardioprotective effect by combating mitochondrial dysfunction, implicating its potential to be adopted in DCM therapies. Therefore, the aim of this review is to provide a concise overview of mitochondrial dysfunction in the development of DCM and the potential role of phenolic acids in combating cardiac mitochondrial dysfunction. Such information can be used for future development of phenolic acids as means of treating DCM by alleviating the cardiac mitochondrial dysfunction.
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Affiliation(s)
- Fatin Farhana Jubaidi
- Center for Diagnostic, Therapeutic and Investigative Studies (CODTIS), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Satirah Zainalabidin
- Center for Toxicology and Health Risk Studies (CORE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (S.Z.); (V.M.)
| | - Vanitha Mariappan
- Center for Toxicology and Health Risk Studies (CORE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (S.Z.); (V.M.)
| | - Siti Balkis Budin
- Center for Diagnostic, Therapeutic and Investigative Studies (CODTIS), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
- Correspondence: ; Tel.: +603-9289-7645
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355
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Tao H, Shi P, Xuan HY, Ding XS. DNA methyltransferase-1 inactivation of androgen receptor axis triggers homocysteine induced cardiac fibroblast autophagy in diabetic cardiac fibrosis. Arch Biochem Biophys 2020; 692:108521. [PMID: 32800775 DOI: 10.1016/j.abb.2020.108521] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/05/2020] [Accepted: 07/27/2020] [Indexed: 12/14/2022]
Abstract
Diabetic cardiac fibrosis is one of the main pathological manifestations of diabetic cardiomyopathy (DCM). Cardiac fibroblast autophagy plays critical roles in diabetic cardiac fibrosis, however, the underlying mechanism of cardiac fibroblast autophagy and diabetic cardiac fibrosis still largely unknown. The aim of the study was to investigate the mechanism of DNMT1 mediated DNA methylation alterations control cardiac fibroblast autophagy in diabetic cardiac fibrosis. We employed streptozotocin (STZ)-induced rats DCM, DCM patient and Hcy induced cardiac fibroblast autophagy. Heart tissue sections were stained with H&E, Sirius Red and Masson's trichrome stain. The expression of DNMT1, AR, Collagen genes mRNA was detected by qRT-PCR. MSP and BSP detected the methylation status of the AR promoter. The expression of DNMT1, AR, Collagen and autophagy-related proteins were detected by Western blotting, Immunofluorescence, Immunohistochemistry. Gain and loss function of AR and DNMT1 in cardiac fibroblast was analyzed. DNMT1 inhibition or knockdown elevated the expression of AR in cardiac fibroblast. Furthermore, we found that AR negatively regulation of Hcy induced cardiac fibroblast autophagy. We demonstrated that DNMT1 enhances cardiac fibroblast autophagy in diabetic cardiac fibrosis through inhibiting AR axis. In conclusion, our results provide new insight into the DNMT1 inactivation of AR axis triggers cardiac fibroblast autophagy in diabetic cardiac fibrosis.
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Affiliation(s)
- Hui Tao
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu Province, 210009, PR China; Department of Cardiothoracic Surgery, The Second Hospital of Anhui Medical University, Hefei, 230601, PR China
| | - Peng Shi
- Department of Cardiothoracic Surgery, The Second Hospital of Anhui Medical University, Hefei, 230601, PR China
| | - Hai-Yang Xuan
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, PR China.
| | - Xuan-Sheng Ding
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu Province, 210009, PR China.
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356
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Sampaio-Pinto V, Ruiz-Villalba A, Nascimento DS, Pérez-Pomares JM. Bone marrow contribution to the heart from development to adulthood. Semin Cell Dev Biol 2020; 112:16-26. [PMID: 32591270 DOI: 10.1016/j.semcdb.2020.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 02/07/2023]
Abstract
Cardiac chamber walls contain large numbers of non-contractile interstitial cells, including fibroblasts, endothelial cells, pericytes and significant populations of blood lineage-derived cells. Blood cells first colonize heart tissues a few days before birth, although their recruitment from the bloodstream to the cardiac interstitium is continuous and extends throughout adult life. The bone marrow, as the major hematopoietic site of adult individuals, is in charge of renewing all circulating cell types, and it therefore plays a pivotal role in the incorporation of blood cells to the heart. Bone marrow-derived cells are instrumental to tissue homeostasis in the steady-state heart, and are major effectors in cardiac disease progression. This review will provide a comprehensive approach to bone marrow-derived blood cell functions in the heart, and discuss aspects related to hot topics in the cardiovascular field like cell-based heart regeneration strategies.
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Affiliation(s)
- Vasco Sampaio-Pinto
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; INEB - Instituto Nacional de Engenharia Biomédica, Universidade do Porto, Porto, Portugal; ICBAS - Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal; Department of Cardiology, CARIM School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; Department of Molecular Genetics, Faculty of Sciences and Engineering, Maastricht University, Maastricht, the Netherlands
| | - Adrián Ruiz-Villalba
- Department of Animal Biology, Institute of Biomedicine of Málaga (IBIMA), Faculty of Sciences, University of Málaga, Málaga, Spain; Andalusian Centre for Nanomedicine and Biotechnology (BIONAND), Campanillas, Málaga, Spain
| | - Diana S Nascimento
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; INEB - Instituto Nacional de Engenharia Biomédica, Universidade do Porto, Porto, Portugal; ICBAS - Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal.
| | - José M Pérez-Pomares
- Department of Animal Biology, Institute of Biomedicine of Málaga (IBIMA), Faculty of Sciences, University of Málaga, Málaga, Spain; Andalusian Centre for Nanomedicine and Biotechnology (BIONAND), Campanillas, Málaga, Spain.
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357
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Song YJ, Zhong CB, Wu W. Cardioprotective effects of melatonin: Focusing on its roles against diabetic cardiomyopathy. Biomed Pharmacother 2020; 128:110260. [PMID: 32447213 DOI: 10.1016/j.biopha.2020.110260] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/01/2020] [Accepted: 05/10/2020] [Indexed: 02/06/2023] Open
Abstract
Melatonin is a pineal-produced indole known for its anti-aging, antiapoptotic and antioxidant properties. In past decades, the protective potentials of melatonin for cardiovascular diseases, such as atherosclerosis and myocardial infarction, have been widely revealed, triggering more investigations focused on other cardioprotective effects of melatonin. Recently, the roles of melatonin in diabetic cardiomyopathy (DCM) have attracted increased attention. In this regard, researchers found that melatonin attenuated cardiac fibrosis and hypertrophy, thus interrupting the development of DCM. Retinoid-related orphan receptor α is a key melatonin receptor that contributed to the cardioprotective effect of melatonin in hearts with DCM. For the downstream mechanisms, the inhibition of mammalian STE20-like kinase 1 plays a pivotal role, which exerts antiapoptotic and proautophagic effects, thus enhancing cardiac tolerance in high-glucose conditions. In addition, other signalling mechanisms, such as sirtuin-1/peroxisome proliferator-activated receptor gamma-coactivator alpha and endoplasmic reticulum-related signalling, are also involved in the protective effects of melatonin on cardiomyocytes under diabetic conditions. This review will focus on the protective signalling mechanisms regulated by melatonin and provide a better understanding of the therapeutic applications of melatonin signalling in DCM.
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Affiliation(s)
- Yan-Jun Song
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, 1 Shuai Fu Yuan, Beijing, 100730, PR China.
| | - Chong-Bin Zhong
- Department of Cardiology, Heart Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, 510282, PR China.
| | - Wei Wu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, 1 Shuai Fu Yuan, Beijing, 100730, PR China.
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358
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Sabouret P, Galati G, Angoulvant D, Germanova O, Castelletti S, Pathak A, Metra M, Margonato A. The interplay between cardiology and diabetology: a renewed collaboration to optimize cardiovascular prevention and heart failure management. EUROPEAN HEART JOURNAL. CARDIOVASCULAR PHARMACOTHERAPY 2020; 6:394-404. [DOI: 10.1093/ehjcvp/pvaa051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 04/14/2020] [Accepted: 05/06/2020] [Indexed: 02/07/2023]
Abstract
Abstract
Type 2 diabetes mellitus (T2DM) portends high risk of atherosclerotic cardiovascular (CV) events and of CV mortality; moreover, this group of patients has a very high probability of developing heart failure (HF). In this review, we discuss new advances in pharmacological treatment both in CV prevention and in HF management with a special focus on T2DM patients. A large number of randomized clinical trials and meta-analyses provided strong evidence about therapeutic strategies acting on glucose metabolism, such as GLP-1 RA and SGLT2i and about lipid-lowering treatment, such as PCSK9i and icosapent ethyl. Moreover, SGLT2i demonstrated strong evidence of benefit particularly in HF management both in diabetic and non-diabetic patients. The pathophysiological bases of multiple mechanisms of benefit of this class of drug explain the unexpected and remarkable results demonstrated both by prevention trials and by trials dedicated only to HF (like DAPA-HF). These, new drugs in the CV therapeutic armamentarium are establishing a new comprehensive approach from prevention to therapy of HF, giving more emphasis on HF classification in four stages (A→D). New therapies, which are on the horizon, promise to further reduce CV mortality and morbidity in HF patients irrespective of diabetic status.
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Affiliation(s)
- Pierre Sabouret
- Cardiology Department, Heart Institute and Action Group, Pitié-Salpétrière, Sorbonne University Paris, Paris, France
| | - Giuseppe Galati
- Heart Failure Unit, Division of Cardiology, Department of Cardiothoracic and Vascular, San Raffaele Hospital, Scientific Institute (IRCCS), Via Olgettina 60, 20132 Milan, Italy
| | - Denis Angoulvant
- Cardiology Department, Loire Valley Cardiovascular Collaboration & EA4245, CHRU de Tours & Tours University, Boulevard Tonnellé 237000, Tours, France
| | - Olga Germanova
- Department of Diagnostic Medicine and Imaging, Samara State Medical University, Samara, Russian Federation
| | - Silvia Castelletti
- Istituto Auxologico Italiano (IRCCS), Center for Cardiac Arrhythmias of Genetic Origin, Milan, Italy
| | - Atul Pathak
- Department of Cardiovascular Medicine, Centre Hospitalier Princesse Grace, Avenue Pasteur 1, 98000, Monaco, Monaco
| | - Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Alberto Margonato
- Heart Failure Unit, Division of Cardiology, Department of Cardiothoracic and Vascular, San Raffaele Hospital, Scientific Institute (IRCCS), Via Olgettina 60, 20132 Milan, Italy
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359
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Role of Oxidative Stress in Metabolic and Subcellular Abnormalities in Diabetic Cardiomyopathy. Int J Mol Sci 2020; 21:ijms21072413. [PMID: 32244448 PMCID: PMC7177292 DOI: 10.3390/ijms21072413] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/17/2020] [Accepted: 03/29/2020] [Indexed: 01/16/2023] Open
Abstract
Although the presence of cardiac dysfunction and cardiomyopathy in chronic diabetes has been recognized, the pathophysiology of diabetes-induced metabolic and subcellular changes as well as the therapeutic approaches for the prevention of diabetic cardiomyopathy are not fully understood. Cardiac dysfunction in chronic diabetes has been shown to be associated with Ca2+-handling abnormalities, increase in the availability of intracellular free Ca2+ and impaired sensitivity of myofibrils to Ca2+. Metabolic derangements, including depressed high-energy phosphate stores due to insulin deficiency or insulin resistance, as well as hormone imbalance and ultrastructural alterations, are also known to occur in the diabetic heart. It is pointed out that the activation of the sympathetic nervous system and renin-angiotensin system generates oxidative stress, which produces defects in subcellular organelles including sarcolemma, sarcoplasmic reticulum and myofibrils. Such subcellular remodeling plays a critical role in the pathogenesis of diabetic cardiomyopathy. In fact, blockade of the effects of neurohormonal systems has been observed to attenuate oxidative stress and occurrence of subcellular remodeling as well as metabolic abnormalities in the diabetic heart. This review is intended to describe some of the subcellular and metabolic changes that result in cardiac dysfunction in chronic diabetes. In addition, the therapeutic values of some pharmacological, metabolic and antioxidant interventions will be discussed. It is proposed that a combination therapy employing some metabolic agents or antioxidants with insulin may constitute an efficacious approach for the prevention of diabetic cardiomyopathy.
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360
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Bi Y, Zhang Y, Ren J. Phosphoinositide 3-kinase therapy in diabetic cardiomyopathy: unravelling an enigma. Am J Physiol Heart Circ Physiol 2020; 318:H1029-H1031. [PMID: 32167783 DOI: 10.1152/ajpheart.00160.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Yaguang Bi
- Department of Cardiology, and Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital Fudan University, Shanghai, China.,Center for Cardiovascular Research and Alternative Medicine, University of Wyoming College of Health Sciences, Laramie, Wyoming
| | - Yingmei Zhang
- Department of Cardiology, and Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital Fudan University, Shanghai, China
| | - Jun Ren
- Department of Cardiology, and Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital Fudan University, Shanghai, China.,Center for Cardiovascular Research and Alternative Medicine, University of Wyoming College of Health Sciences, Laramie, Wyoming
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