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Present Insights on Cardiomyopathy in Diabetic Patients
The pathogenesis of diabetic cardiomyopathy (DCM) is partially understood and is likely to be multifactorial, involving metabolic disturbances, hypertension and cardiovascular autonomic neuropathy (CAN). Therefore, an important need remains to further delineate the basic mechanisms of diabetic cardi...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Bentham Science Publishers
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5101638/ https://www.ncbi.nlm.nih.gov/pubmed/26364799 http://dx.doi.org/10.2174/1573399812666150914120529 |
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author | Felício, João Soares Koury, Camila Cavalcante Carvalho, Carolina Tavares Neto, João Felício Abrahão Miléo, Karem Barbosa Arbage, Thaís Pontes Silva, Denisson Dias Ferreira de Oliveira, Alana Peixoto, Amanda Soares Junior, Antônio Bentes Figueiredo Ribeiro dos Santos, Ândrea Kely Campos Yamada, Elizabeth Sumi Zanella, Maria Teresa |
author_facet | Felício, João Soares Koury, Camila Cavalcante Carvalho, Carolina Tavares Neto, João Felício Abrahão Miléo, Karem Barbosa Arbage, Thaís Pontes Silva, Denisson Dias Ferreira de Oliveira, Alana Peixoto, Amanda Soares Junior, Antônio Bentes Figueiredo Ribeiro dos Santos, Ândrea Kely Campos Yamada, Elizabeth Sumi Zanella, Maria Teresa |
author_sort | Felício, João Soares |
collection | PubMed |
description | The pathogenesis of diabetic cardiomyopathy (DCM) is partially understood and is likely to be multifactorial, involving metabolic disturbances, hypertension and cardiovascular autonomic neuropathy (CAN). Therefore, an important need remains to further delineate the basic mechanisms of diabetic cardiomyopathy and to apply them to daily clinical practice. We attempt to detail some of these underlying mechanisms, focusing in the clinical features and management. The novelty of this review is the role of CAN and reduction of blood pressure descent during sleep in the development of DCM. Evidence has suggested that CAN might precede left ventricular hypertrophy and diastolic dysfunction in normotensive patients with type 2 diabetes, serving as an early marker for the evaluation of preclinical cardiac abnormalities. Additionally, a prospective study demonstrated that an elevation of nocturnal systolic blood pressure and a loss of nocturnal blood pressure fall might precede the onset of abnormal albuminuria and cardiovascular events in hypertensive normoalbuminuric patients with type 2 diabetes. Therefore, existing microalbuminuria could imply the presence of myocardium abnormalities. Considering that DCM could be asymptomatic for a long period and progress to irreversible cardiac damage, early recognition and treatment of the preclinical cardiac abnormalities are essential to avoid severe cardiovascular outcomes. In this sense, we recommend that all type 2 diabetic patients, especially those with microalbuminuria, should be regularly submitted to CAN tests, Ambulatory Blood Pressure Monitoring and echocardiography, and treated for any abnormalities in these tests in the attempt of reducing cardiovascular morbidity and mortality. |
format | Online Article Text |
id | pubmed-5101638 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Bentham Science Publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-51016382016-11-30 Present Insights on Cardiomyopathy in Diabetic Patients Felício, João Soares Koury, Camila Cavalcante Carvalho, Carolina Tavares Neto, João Felício
Abrahão Miléo, Karem Barbosa Arbage, Thaís Pontes Silva, Denisson Dias Ferreira de Oliveira, Alana Peixoto, Amanda Soares Junior, Antônio Bentes Figueiredo Ribeiro dos Santos, Ândrea Kely Campos Yamada, Elizabeth Sumi Zanella, Maria Teresa Curr Diabetes Rev Article The pathogenesis of diabetic cardiomyopathy (DCM) is partially understood and is likely to be multifactorial, involving metabolic disturbances, hypertension and cardiovascular autonomic neuropathy (CAN). Therefore, an important need remains to further delineate the basic mechanisms of diabetic cardiomyopathy and to apply them to daily clinical practice. We attempt to detail some of these underlying mechanisms, focusing in the clinical features and management. The novelty of this review is the role of CAN and reduction of blood pressure descent during sleep in the development of DCM. Evidence has suggested that CAN might precede left ventricular hypertrophy and diastolic dysfunction in normotensive patients with type 2 diabetes, serving as an early marker for the evaluation of preclinical cardiac abnormalities. Additionally, a prospective study demonstrated that an elevation of nocturnal systolic blood pressure and a loss of nocturnal blood pressure fall might precede the onset of abnormal albuminuria and cardiovascular events in hypertensive normoalbuminuric patients with type 2 diabetes. Therefore, existing microalbuminuria could imply the presence of myocardium abnormalities. Considering that DCM could be asymptomatic for a long period and progress to irreversible cardiac damage, early recognition and treatment of the preclinical cardiac abnormalities are essential to avoid severe cardiovascular outcomes. In this sense, we recommend that all type 2 diabetic patients, especially those with microalbuminuria, should be regularly submitted to CAN tests, Ambulatory Blood Pressure Monitoring and echocardiography, and treated for any abnormalities in these tests in the attempt of reducing cardiovascular morbidity and mortality. Bentham Science Publishers 2016-12 2016-12 /pmc/articles/PMC5101638/ /pubmed/26364799 http://dx.doi.org/10.2174/1573399812666150914120529 Text en © 2016 Bentham Science Publishers https://creativecommons.org/licenses/by-nc/4.0/legalcode This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) ( https://creativecommons.org/licenses/by-nc/4.0/legalcode ), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited. |
spellingShingle | Article Felício, João Soares Koury, Camila Cavalcante Carvalho, Carolina Tavares Neto, João Felício Abrahão Miléo, Karem Barbosa Arbage, Thaís Pontes Silva, Denisson Dias Ferreira de Oliveira, Alana Peixoto, Amanda Soares Junior, Antônio Bentes Figueiredo Ribeiro dos Santos, Ândrea Kely Campos Yamada, Elizabeth Sumi Zanella, Maria Teresa Present Insights on Cardiomyopathy in Diabetic Patients |
title | Present Insights on Cardiomyopathy in Diabetic Patients |
title_full | Present Insights on Cardiomyopathy in Diabetic Patients |
title_fullStr | Present Insights on Cardiomyopathy in Diabetic Patients |
title_full_unstemmed | Present Insights on Cardiomyopathy in Diabetic Patients |
title_short | Present Insights on Cardiomyopathy in Diabetic Patients |
title_sort | present insights on cardiomyopathy in diabetic patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5101638/ https://www.ncbi.nlm.nih.gov/pubmed/26364799 http://dx.doi.org/10.2174/1573399812666150914120529 |
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