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Diabetes increases the risk of developing heart disease by several-fold, while more than half of all diabetic patients develop coronary heart disease and/or hypertension. Heart involvement in diabetes goes beyond the damage to coronary arteries due to the progress of atherosclerotic process. Diabetes and its pathophysiological consequences are able to induce direct alterations and abnormalities in the cardiac muscle functions. Such dysfunctions lead to impairment in cardiac contractility and ventricle compliance which create the condition called “diabetic cardiomyopathy”. The terms “diabetic cardiomyopathy” were initially introduced in 1972 by Rubler in order to define structural and functional abnormalities in the myocardium of diabetic patients without coronary artery disease or hypertension. Multiple mechanisms were supposed to generate such a disease and they include: alterations in cell survival pathways, extracellular matrix increased formation, post-translation protein modification and glucose metabolism. Furthermore, all these alterations are able to macroscopically affect the heart. Diabetic cardiomyopathy is effectively characterized by a disproportionate increase in left ventricular mass and myocardial fibrosis. This is the background for the development of ventricular wall stiffness and increased diastolic relaxation time which constitute the early moments of that diastolic dysfunction characterizing early stages of cardiomyopathy. Marco Matteo Ciccone, Endothelial Function in Pre-diabetes, Diabetes and Diabetic Cardiomyopathy: A Review
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Last date updated on November, 2020