The vulnerable myocardium

Summary

Cardiovascular disease is the major cause of morbidity and mortality in subjects suffering from diabetes mellitus. While coronary artery disease is the leading cause of cardiac complications in diabetics, it is widely recognized that diabetes increases the risk for the development of heart failure independently of coronary heart disease and hypertension. This increased susceptibility of the diabetic heart to develop structural and functional impairment is termed diabetic cardiomyopathy. The number of different mechanisms proposed to contribute to diabetic cardiomyopathy is steadily increasing and underlines the complexity of this cardiac entity.

In this review the mechanisms that account for the increased myocardial vulnerability in diabetic cardiomyopathy are discussed.

Zusammenfassung

Kardiovaskuläre Erkrankungen sind die Hauptursache von Morbidität und Mortalität im Diabetes mellitus. Kardiale Komplikationen sind meist die Folge einer koronaren Herzerkrankung. Mittlerweile wird zunehmend wahrgenommen, dass Diabetes unabhängig von koronarer Herzerkrankung und Bluthochdruck das Risiko für die Entwicklung einer Herzinsuffizienz erhöht. Diese Prädisposition, sowohl strukturelle als auch funktionelle Beeinträchtigungen zu entwickeln, wird auch als diabetische Kardiomyopathie bezeichnet. Die wachsende Zahl unterschiedlicher Mechanismen, die als Ursache diskutiert werden, unterstreichen die Komplexität dieser kardialen Entität.

In dieser Übersicht sollen die Mechanismen erläutert werden, die der diabetischen Kardiomyopathie zugrunde liegen.

Keywords

Diabetes - cardiomyopathy - energy metabolism - mitochondria

Schlüsselwörter

Diabetes - Kardiomyopathie - Energiestoffwechsel - Mitochondrien

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