Banerjee Stacy, Peterson Linda R
Washington University School of Medicine, Department of Medicine, St. Louis, MO 63110, USA.
Curr Cardiol Rep. 2007 Apr;9(2):143-9. doi: 10.1007/BF02938341.
Obesity, insulin resistance, and their frequent complication of type 2 diabetes are risk factors for left ventricular diastolic dysfunction, systolic dysfunction, and clinical heart failure. Although obesity, insulin resistance, and diabetes are risk factors for coronary artery disease, and hence ischemic cardiomyopathy-related heart failure, there is increasing evidence that these three risk factors are implicated in the development of cardiac dysfunction not related to epicardial coronary disease. There are several mechanisms by which this triad may cause cardiac dysfunction, including alterations in myocardial metabolism, which may initially be adaptations but evolve into maladaptive responses over time. Recent advances in our understanding of these mechanisms will aid in the development of novel therapies, including metabolic manipulations that could prevent and treat cardiac dysfunction in patients with obesity, insulin resistance, and diabetes.
肥胖、胰岛素抵抗及其常见并发症2型糖尿病是左心室舒张功能障碍、收缩功能障碍和临床心力衰竭的危险因素。尽管肥胖、胰岛素抵抗和糖尿病是冠状动脉疾病的危险因素，进而也是缺血性心肌病相关心力衰竭的危险因素，但越来越多的证据表明，这三种危险因素与非心外膜冠状动脉疾病相关的心脏功能障碍的发生有关。这三者可能通过多种机制导致心脏功能障碍，包括心肌代谢的改变，这种改变最初可能是适应性的，但随着时间的推移会演变成适应不良的反应。我们对这些机制理解的最新进展将有助于开发新的治疗方法，包括可预防和治疗肥胖、胰岛素抵抗和糖尿病患者心脏功能障碍的代谢干预措施。
