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Review

Pathophysiology and Treatment of Diabetic Cardiomyopathy and Heart Failure in Patients with Diabetes Mellitus

by
Kazufumi Nakamura
1,*,
Toru Miyoshi
1,
Masashi Yoshida
1,
Satoshi Akagi
1,
Yukihiro Saito
1,
Kentaro Ejiri
1,
Naoaki Matsuo
1,
Keishi Ichikawa
1,
Keiichiro Iwasaki
1,
Takanori Naito
1,
Yusuke Namba
1,
Masatoki Yoshida
1,
Hiroki Sugiyama
2 and
Hiroshi Ito
1
1
Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
2
Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama 700-8511, Japan
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2022, 23(7), 3587; https://doi.org/10.3390/ijms23073587
Submission received: 14 February 2022 / Revised: 21 March 2022 / Accepted: 23 March 2022 / Published: 25 March 2022
(This article belongs to the Special Issue Molecular Pathways in Cardio-Metabolic Disease)
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Abstract

There is a close relationship between diabetes mellitus and heart failure, and diabetes is an independent risk factor for heart failure. Diabetes and heart failure are linked by not only the complication of ischemic heart disease, but also by metabolic disorders such as glucose toxicity and lipotoxicity based on insulin resistance. Cardiac dysfunction in the absence of coronary artery disease, hypertension, and valvular disease is called diabetic cardiomyopathy. Diabetes-induced hyperglycemia and hyperinsulinemia lead to capillary damage, myocardial fibrosis, and myocardial hypertrophy with mitochondrial dysfunction. Lipotoxicity with extensive fat deposits or lipid droplets is observed on cardiomyocytes. Furthermore, increased oxidative stress and inflammation cause cardiac fibrosis and hypertrophy. Treatment with a sodium glucose cotransporter 2 (SGLT2) inhibitor is currently one of the most effective treatments for heart failure associated with diabetes. However, an effective treatment for lipotoxicity of the myocardium has not yet been established, and the establishment of an effective treatment is needed in the future. This review provides an overview of heart failure in diabetic patients for the clinical practice of clinicians.
Keywords: heart failure; lipotoxicity; SGLT2 inhibitor heart failure; lipotoxicity; SGLT2 inhibitor

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MDPI and ACS Style

Nakamura, K.; Miyoshi, T.; Yoshida, M.; Akagi, S.; Saito, Y.; Ejiri, K.; Matsuo, N.; Ichikawa, K.; Iwasaki, K.; Naito, T.; et al. Pathophysiology and Treatment of Diabetic Cardiomyopathy and Heart Failure in Patients with Diabetes Mellitus. Int. J. Mol. Sci. 2022, 23, 3587. https://doi.org/10.3390/ijms23073587

AMA Style

Nakamura K, Miyoshi T, Yoshida M, Akagi S, Saito Y, Ejiri K, Matsuo N, Ichikawa K, Iwasaki K, Naito T, et al. Pathophysiology and Treatment of Diabetic Cardiomyopathy and Heart Failure in Patients with Diabetes Mellitus. International Journal of Molecular Sciences. 2022; 23(7):3587. https://doi.org/10.3390/ijms23073587

Chicago/Turabian Style

Nakamura, Kazufumi, Toru Miyoshi, Masashi Yoshida, Satoshi Akagi, Yukihiro Saito, Kentaro Ejiri, Naoaki Matsuo, Keishi Ichikawa, Keiichiro Iwasaki, Takanori Naito, and et al. 2022. "Pathophysiology and Treatment of Diabetic Cardiomyopathy and Heart Failure in Patients with Diabetes Mellitus" International Journal of Molecular Sciences 23, no. 7: 3587. https://doi.org/10.3390/ijms23073587

APA Style

Nakamura, K., Miyoshi, T., Yoshida, M., Akagi, S., Saito, Y., Ejiri, K., Matsuo, N., Ichikawa, K., Iwasaki, K., Naito, T., Namba, Y., Yoshida, M., Sugiyama, H., & Ito, H. (2022). Pathophysiology and Treatment of Diabetic Cardiomyopathy and Heart Failure in Patients with Diabetes Mellitus. International Journal of Molecular Sciences, 23(7), 3587. https://doi.org/10.3390/ijms23073587

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