Cardiovasc Prev Pharmacother.  2021 Apr;3(2):21-30. 10.36011/cpp.2021.3.e4.

Diabetes and Heart Failure

• Rhee EJ

• KMID: 2536943
• DOI: http://doi.org/10.36011/cpp.2021.3.e4

Abstract

Heart failure (HF) in patients with diabetes mellitus has long been considered a consequence of coronary artery disease (CAD). However, recent epidemiological evidence on patients with diabetes showed a significantly increased prevalence of HF in patients with no significant stenosis in the coronary artery. As such, these are thought to be separate entities of diabetic complications. Therefore, HF in patients with diabetes is now considered an independent disease entity of the ‘diabetic heart.’ The mechanism of ‘diabetic heart’ could be due to CAD and diabetic cardiomyopathy caused by altered energy metabolism in the myocardium and advanced glycation end-product accumulation, altered calcium handling, and oxidative stress in the myocardium. Recent cardiovascular outcome trials of anti-diabetic medications have shown the protective effects of certain drugs against HF in patients with and without diabetes. In this review, the relationship between diabetes and the treatment and prevention of HF is summarized.

Keyword

Cardiomyopathies; Diabetes complications; Diabetes mellitus; Diabetic cardiomyopathies; Heart failure

Figure

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  Figure 1. Mechanism of HF in diabetes. Adapted from the article of Dunlay et al. (Circulation 2019;140:e294-324).24) AGE = advanced glycation end product; CAD = coronary artery disease; HF, heart failure; LVH = left ventricular hypertrophy; RAAS = renin-angiotensin aldosterone system.

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