Diabetic Cardiomyopathy as a Clinical Entity: Is It a Myth?

Abstract

Dilated cardiomyopathy (DCM) is a common form of cardiomyopathy that affects the cardiac muscle. It is a life-threatening condition that causes heart failure as it decreases the myocardial ability to pump sufficient blood throughout the body. Numerous causes trigger DCM without pathophysiology; however, the key concept is a decrease in the systolic function of either the left ventricle or of both the left and right ventricles. Long-term diabetes plays an important role in the pathogenesis of DCM in the form of diabetic cardiomyopathy. Diabetic cardiomyopathy is a non-ischemic form of DCM, which is associated with diabetes. It is unrelated to atherosclerosis and hypertension. The PubMed and Google Scholar databases were used to identify the relevant studies related to diabetes and DCM. We found that diabetes was associated with cardiac muscle injury by activating the renin-angiotensin-aldosterone system, myocardial inflammation, and fibrosis. Based on the available data, we concluded that there is strong evidence to support the interrelation of DCM and diabetes.

Keywords: diabetic cardiomyopathy; dilated cardiomyopthy; type 2 diabetes mellitus.

Figure 1. The genetic association of dilated cardiomyopathy and diabetes.

This figure summarizes the inter-relationship between dilated cardiomyopathy and diabetes in the form of genetic diseases of Alström and Bardet-Biedl syndromes.

Figure 2. Pathophysiology of diabetic cardiomyopathy.

This figure summarizes four different pathophysiologic changes due to diabetic cardiomyopathy in the myocardial tissue by activating RAAS, altering calcium homeostasis, lowering HDL, and increasing free radicals.