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Review
. 2020 Apr 21;21(8):2896.
doi: 10.3390/ijms21082896.

Diabetic Cardiomyopathy and Ischemic Heart Disease: Prevention and Therapy by Exercise and Conditioning

Antonio Crisafulli  1 , Pasquale Pagliaro  2 , Silvana Roberto  1 , Lucia Cugusi  3 , Giuseppe Mercuro  1 , Antigone Lazou  4 , Christophe Beauloye  5   6 , Luc Bertrand  5 , Derek J Hausenloy  7   8   9   10   11 , Manuela Aragno  2 , Claudia Penna  2
Affiliations
Review

Diabetic Cardiomyopathy and Ischemic Heart Disease: Prevention and Therapy by Exercise and Conditioning

Antonio Crisafulli et al. Int J Mol Sci. .

Abstract

Metabolic syndrome, diabetes, and ischemic heart disease are among the leading causes of death and disability in Western countries. Diabetic cardiomyopathy is responsible for the most severe signs and symptoms. An important strategy for reducing the incidence of cardiovascular disease is regular exercise. Remote ischemic conditioning has some similarity with exercise and can be induced by short periods of ischemia and reperfusion of a limb, and it can be performed in people who cannot exercise. There is abundant evidence that exercise is beneficial in diabetes and ischemic heart disease, but there is a need to elucidate the specific cardiovascular effects of emerging and unconventional forms of exercise in people with diabetes. In addition, remote ischemic conditioning may be considered among the options to induce beneficial effects in these patients. The characteristics and interactions of diabetes and ischemic heart disease, and the known effects of exercise and remote ischemic conditioning in the presence of metabolic syndrome and diabetes, are analyzed in this brief review.

Keywords: diabetic cardiomyopathy; exercise; hyperglycemia; ischemia/reperfusion injury; metabolism; mitochondria; remote conditioning.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Metabolic pathways leading to advanced glycation end products (AGE) generation and cellular effects after interaction of AGE with the receptor for AGE (RAGE) (AR, aldose reductase; SDH, sorbitol dehydrogenase; 3-PK, 3-phosphokinase; for other acronyms see the list of Abbreviations).
Figure 2
Figure 2
Main factors leading from hyperglycemia to cardiotoxicity (for acronyms see the list of Abbreviations).
Figure 3
Figure 3
Risk factors leading to diabetes and effects on the cardiovascular system.
Figure 4
Figure 4
Overview of cardioprotective mechanisms and pathways altered/inhibited by diabetic condition.
Figure 5
Figure 5
Putative effects of exercise on the cardiovascular system.
See this image and copyright information in PMC

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