Vascular endothelial dysfunction, a major mediator in diabetic cardiomyopathy

• Published in: Acta pharmacologica Sinica Vol. 40; no. 1; pp. 1 - 8
• Main Authors: Knapp, Maura, Tu, Xin, Wu, Rongxue
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-01-2019; Nature Publishing Group
• Subjects: Animals; Biomedical and Life Sciences; Biomedicine; Cardiomyopathy; Cardiovascular disease; Congestive heart failure; Coronary artery; Coronary artery disease; Diabetes; Diabetes Complications - physiopathology; Diabetes mellitus; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - physiopathology; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - physiopathology; Diabetic Angiopathies - etiology; Diabetic Angiopathies - physiopathology; Diabetic Cardiomyopathies - etiology; Diabetic Cardiomyopathies - physiopathology; Endothelium; Endothelium, Vascular - physiopathology; Glycolysis - physiology; Health risks; Human Umbilical Vein Endothelial Cells; Humans; Hyperglycemia; Hyperglycemia - complications; Immunology; Inflammation; Internal Medicine; Ischemia; Medical Microbiology; Microvasculature; Mitochondria - physiology; Morbidity; Nitric oxide; Nitric Oxide - antagonists & inhibitors; Oxidation; Oxidative stress; Oxidative Stress - physiology; Pharmacology/Toxicology; Public health; Review; Review Article; Risk factors; Vaccine; diabetic cardiovascular complications; endothelium; heart failure; metabolism; cardiomyopathy; diabetes; vascular
• ISSN: 1671-4083; 1745-7254
• DOI: 10.1038/s41401-018-0042-6

Diabetes mellitus is currently a major public health problem. A common complication of diabetes is cardiac dysfunction, which is recognized as a microvascular disease that leads to morbidity and mortality in diabetic patients. While ischemic events are commonly observed in diabetic patients, the risk for developing heart failure is also increased, independent of the severity of coronary artery disease and hypertension. This diabetes-associated clinical entity is considered a distinct disease process referred to as “diabetic cardiomyopathy”. However, it is not clear how diabetes promotes cardiac dysfunction. Vascular endothelial dysfunction is thought to be one of the key risk factors. The impact of diabetes on the endothelium involves several alterations, including hyperglycemia, fatty acid oxidation, reduced nitric oxide (NO), oxidative stress, inflammatory activation, and altered barrier function. The current review provides an update on mechanisms that specifically target endothelial dysfunction, which may lead to diabetic cardiomyopathy.