Present insights on cardiomyopathy in diabetic patients

Present insights on cardiomyopathy in diabetic patients

Author Felicio, Joao Soares Google Scholar
Koury, Camila Cavalcante Google Scholar
Carvalho, Carolina Tavares Google Scholar
Abrahao Neto, Joao Felicio Google Scholar
Mileo, Karem Barbosa Google Scholar
Arbage, Thais Pontes Google Scholar
Silva, Denisson Dias Google Scholar
de Oliveira, Alana Ferreira Google Scholar
Peixoto, Amanda Soares Google Scholar
Figueiredo Junior, Antonio Bentes Google Scholar
Ribeiro dos Santos, Andrea Kely Campos Google Scholar
Yamada, Elizabeth Sumi Google Scholar
Zanella, Maria Teresa Autor UNIFESP Google Scholar
Abstract The pathogenesis of diabetic cardiomyopathy (DCM) is partially understood and is likely to be multifactorial, involving metabolic disturbances, hypertension and cardiovascular autonomic neuropathy (CAN). Therefore, an important need remains to further delineate the basic mechanisms of diabetic cardiomyopathy and to apply them to daily clinical practice. We attempt to detail some of these underlying mechanisms, focusing in the clinical features and management. The novelty of this review is the role of CAN and reduction of blood pressure descent during sleep in the development of DCM. Evidence has suggested that CAN might precede left ventricular hypertrophy and diastolic dysfunction in normotensive patients with type 2 diabetes, serving as an early marker for the evaluation of preclinical cardiac abnormalities. Additionally, a prospective study demonstrated that an elevation of nocturnal systolic blood pressure and a loss of nocturnal blood pressure fall might precede the onset of abnormal albuminuria and cardiovascular events in hypertensive normoalbuminuric patients with type 2 diabetes. Therefore, existing microalbuminuria could imply the presence of myocardium abnormalities. Considering that DCM could be asymptomatic for a long period and progress to irreversible cardiac damage, early recognition and treatment of the preclinical cardiac abnormalities are essential to avoid severe cardiovascular outcomes. In this sense, we recommend that all type 2 diabetic patients, especially those with microalbuminuria, should be regularly submitted to CAN tests, Ambulatory Blood Pressure Monitoring and echocardiography, and treated for any abnormalities in these tests in the attempt of reducing cardiovascular morbidity and mortality.
Keywords Diabetic Cardiomyopathy
Diabetes Mellitus
Left Ventricular Hypertrophy
Left Ventricular Dysfunction
Ambulatorial Blood Pressure Measurement
Diabetic Autonomic NeuropathyLeft-Ventricular Hypertrophy
Ambulatory Blood-Pressure
Glycation End-Products
Cardiovascular Autonomic Neuropathy
Impaired Glucose-Tolerance
Diastolic Dysfunction
Language English
Date 2016
Published in Current Diabetes Reviews. Sharjah, v. 12, n. 4, p. 384-395, 2016.
ISSN 1573-3998 (Sherpa/Romeo, impact factor)
Publisher Hindawi Publishing Corp
Extent 384-395
Access rights Open access Open Access
Type Revisão
Web of Science ID WOS:000405104600008

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