Diabetic cardiomyopathy

 

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Diabetes Mellitus(DM) appears to contribute directly to the development of cardiomyopathy(CMP), rather than solely via coronary atherosclerosis and hypertension. This diabetic CMP has been described in many non-invasive studies and includes changes that occur in LV structure and cardiac function of diabetics. Specifically, diabetics tend to have greater cardiac mass, particularly LV mass, than those without DM. This may be related to an increased adipocyte release of cytokines such as leptin and resistin which have hypertrophic effects on cardiomyocytes. One study looking at a multi-ethnic population found that the likelihood of having LV mass that exceeds the 75th percentile is greater in patients with T2DM, even after adjusting for covariates. Patients with DM also tend to have a slightly diminished diastolic function compared to nondiabetics. One possible mechanism could be that increased triglyceride synthesis in patients with DM leads to increased myocardial triglyceride content. Increased cardiac triglyceride accumulation is associated with lipotoxicity and altered calcium haemostasis in the myocardium, both of which negatively impact diastolic function. This could facilitate justify the finding that 40%-75% of people with DM and no signs of unconcealed arterial blood vessel malady (CAD) suffer from pulsation dysfunction.

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