Korean Diabetes J.  2009 Feb;33(1):9-12. 10.4093/kdj.2009.33.1.9.

Diabetic Cardiomyopathy

• Kim SA
• Ha JW

• KMID: 2222477
• DOI: http://doi.org/10.4093/kdj.2009.33.1.9

Abstract

Cardiovascular disease is the most common cause of death in patients with diabetes mellitus (DM). In particular, the focus of many studies has been on ischemic heart disease, as it is a eading cause of death in diabetic patients. However, independent of coronary artery disease, DM can also lead to cardiac structural and functional changes, supporting the presence of diabetic cardiomyopathy. The pathologic mechanismin the development of diabetic cardiomyopathy is multifactorial including metabolic disturbance, myocardial fibrosis, microvascular disease, and autonomic dysfunction. Functionally, diabetic patients have a higher prevalence of LV (left ventricle) diastolic dysfunction. Because most diabetic patients with early myocardial disease have a wide spectrum of diastolic dysfunction at rest, assessment of LV functional reserve during exercise is helpful for early identification of myocardial dysfunction. Recent research has demonstrated that LV diastolic functional reserve (DFR) assessed by diastolic stress echocardiography was significantly reduced in patients with DM, compared with a control group, suggesting DFR might be an early indicator of diabetic cardiomyopathy. Glycemic control might be the most important and basic therapeutic strategy for preventing the development of diabetic cardiomyopathy. However, more extensive studies are needed to garner further evidence of preventive and therapeutic strategies of diabetic cardiomyopathy.

Keyword

Cardiomyopathy; Diabetes mellitus; Diastole

MeSH Terms

Cardiomyopathies
Cardiovascular Diseases
Cause of Death
Coronary Artery Disease
Diabetes Mellitus
Diabetic Cardiomyopathies
Diastole
Echocardiography, Stress
Fibrosis
Humans
Myocardial Ischemia
Prevalence

Figure

• 

  Fig. 1 A. Change of E' from rest to exercise. Note that an increase in E' with exercise was less pronounced in patients with diabetes. B. The change of E' with exercise was significantly smaller in patients with diabetes compared with the control.

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