Circulation. 2002;105:1727-1733
doi: 10.1161/01.CIR.0000012466.50373.E8
doi: 10.1161/01.CIR.0000012466.50373.E8
(Circulation. 2002;105:1727.)
© 2002 American Heart Association, Inc.
Current Perspective |
Adaptation and Maladaptation of the Heart in Diabetes: Part I
General Concepts
From the Department of Internal Medicine, Division of Cardiology, University of Texas-Houston Medical School, Houston, Tex (H.T., M.E.Y.), and the Cardiology Section, Penn State University College of Medicine, the Milton S. Hershey Medical Center, Hershey, Pa (P.M).
Correspondence to Heinrich Taegtmeyer, MD, DPhil, Department of Internal Medicine, Division of Cardiology, University of Texas-Houston Medical School, 6431 Fannin, MSB 1.246, Houston, TX 77030. E-mail Heinrich.Taegtmeyer@uth.tmc.edu
Key Words: diabetes mellitus • heart failure • cardiovascular diseases
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Introduction |
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Diabetes mellitus (type 2 diabetes) is as much a disease of modern lifestyle as it is a disease of genetic predisposition. Worldwide, there are about 143 million patients with diabetes, almost 5 times more than estimates of 10 years ago.1,2 Heart disease, often presenting as cardiomyopathy, is the leading cause of death among patients with diabetes mellitus (Figure 1). 3 Like diabetes, the prevalence of heart failure also continues to rise in Western countries.4 Diabetes, in turn, is the largest comorbidity of patients with heart failure and adversely affects outcomes of cardiovascular disease.5 The trend is unmistakable; both insulin resistance and heart failure have emerged as major worldwide epidemics. It is therefore timely to take a fresh look at the effects of diabetes on the heart.
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The difficulties in making a causal connection between diabetes and heart failure are formidable. Some simple definitions remain elusive. For example, the distinction between the insulin-deficient (type 1) and insulin-resistant (type 2) forms of diabetes on the one hand, and the distinction between systolic and diastolic dysfunction as causes of heart failure, on the other hand, are hard to define. The known trophic and hemodynamic effects of insulin
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B. E. Suys, N. Katier, R. P.A. Rooman, D. Matthys, L. Op De Beeck, M. V.L. Du Caju, and D. De Wolf Female Children and Adolescents With Type 1 Diabetes Have More Pronounced Early Echocardiographic Signs of Diabetic Cardiomyopathy Diabetes Care, August 1, 2004; 27(8): 1947 - 1953. [Abstract] [Full Text] [PDF]
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L. Raimondi, P. De Paoli, E. Mannucci, G. Lonardo, L. Sartiani, G. Banchelli, R. Pirisino, A. Mugelli, and E. Cerbai Restoration of Cardiomyocyte Functional Properties by Angiotensin II Receptor Blockade in Diabetic Rats Diabetes, July 1, 2004; 53(7): 1927 - 1933. [Abstract] [Full Text] [PDF]
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J. I. Barzilay, R. A. Kronmal, J. S. Gottdiener, N. L. Smith, G. L. Burke, R. Tracy, P. J. Savage, and M. Carlson The association of fasting glucose levels with congestive heart failure in diabetic adults >=65 years: The Cardiovascular Health Study J. Am. Coll. Cardiol., June 16, 2004; 43(12): 2236 - 2241. [Abstract] [Full Text] [PDF]
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J. M. McGavock, S. Mandic, I. Vonder Muhll, R. Z. Lewanczuk, H. A. Quinney, D. A. Taylor, R. C. Welsh, and M. Haykowsky Low Cardiorespiratory Fitness Is Associated With Elevated C-Reactive Protein Levels in Women With Type 2 Diabetes Diabetes Care, February 1, 2004; 27(2): 320 - 325. [Abstract] [Full Text] [PDF]
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B. F. Johnson, R. W. Nesto, M. A. Pfeifer, W. R. Slater, A. I. Vinik, D. A. Chyun, G. Law, F. J.Th. Wackers, and L. H. Young Cardiac Abnormalities in Diabetic Patients With Neuropathy: Effects of aldose reductase inhibitor administration Diabetes Care, February 1, 2004; 27(2): 448 - 454. [Abstract] [Full Text] [PDF]
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M. Desrois, R. J Sidell, D. Gauguier, L. M King, G. K Radda, and K. Clarke Initial steps of insulin signaling and glucose transport are defective in the type 2 diabetic rat heart Cardiovasc Res, February 1, 2004; 61(2): 288 - 296. [Abstract] [Full Text] [PDF]
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H. Taegtmeyer and P. Razeghi Heart disease in diabetes--resist the beginnings J. Am. Coll. Cardiol., January 21, 2004; 43(2): 315 - 315. [Full Text] [PDF]
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S. Haffner and H. Taegtmeyer Epidemic Obesity and the Metabolic Syndrome Circulation, September 30, 2003; 108(13): 1541 - 1545. [Full Text] [PDF]
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M. Scheuermann-Freestone, P. L. Madsen, D. Manners, A. M. Blamire, R. E. Buckingham, P. Styles, G. K. Radda, S. Neubauer, and K. Clarke Abnormal Cardiac and Skeletal Muscle Energy Metabolism in Patients With Type 2 Diabetes Circulation, June 24, 2003; 107(24): 3040 - 3046. [Abstract] [Full Text] [PDF]
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 M. Jessup and S. Brozena Heart Failure N. Engl. J. Med., May 15, 2003; 348(20): 2007 - 2018. [Full Text] [PDF]
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 C. J. Tack Insulin Resistance and Acute Cardiovascular Complications Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2003; 7(1): 85 - 90. [PDF]
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 M. Bartnik, K. Malmberg, and L. Ryden Diabetes and the heart: compromised myocardial function -- a common challenge Eur. Heart J. Suppl., January 1, 2003; 5(suppl_B): B33 - B41. [Abstract] [PDF]
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