University of California, San Diego, Department of Medicine, San Diego, CA, USA.
J Mol Cell Cardiol. 2010 Mar;48(3):524-9. doi: 10.1016/j.yjmcc.2009.06.021. Epub 2009 Jul 9.
In diabetes mellitus, alterations in cardiac structure/function in the absence of ischemic heart disease, hypertension or other cardiac pathologies are termed diabetic cardiomyopathy. In the United States, the prevalence of diabetes mellitus continues to rise and the disease currently affects about 8% of the general population. Hence, the use of appropriate diagnostic strategies for diabetic cardiomyopathy, which may help correctly identify the disease at early stages and implement suitable corrective therapies is imperative. Currently, there is no single diagnostic method for the identification of diabetic cardiomyopathy. Diabetic cardiomyopathy is known to induce changes in cardiac structure such as, myocardial hypertrophy, fibrosis and fat droplet deposition. Early changes in cardiac function are typically manifested as abnormal diastolic function that with time leads to loss of contractile function. Echocardiography based methods currently stand as the preferred diagnostic approach for diabetic cardiomyopathy, due to its wide availability and economical use. In addition to conventional techniques, magnetic resonance imaging and spectroscopy along with contrast agents are now leading new approaches in the diagnosis of myocardial fibrosis, and cardiac and hepatic metabolic changes. These strategies can be complemented with serum biomarkers so they can offer a clear picture as to diabetes-induced changes in cardiac structure/function even at very early stages of the disease. This review article intends to provide a summary of experimental and routine tools currently available to diagnose diabetic cardiomyopathy induced changes in cardiac structure/function. These tools can be reliably used in either experimental models of diabetes or for clinical applications.
在糖尿病中，在没有缺血性心脏病、高血压或其他心脏病理学的情况下发生的心脏结构/功能改变被称为糖尿病心肌病。在美国，糖尿病的患病率持续上升，目前约有 8%的普通人群受到该病的影响。因此，使用适当的诊断策略来诊断糖尿病心肌病至关重要，这可能有助于在早期正确识别疾病并实施适当的纠正治疗。目前，尚无单一的诊断方法可用于识别糖尿病心肌病。已知糖尿病心肌病会引起心脏结构的变化，如心肌肥大、纤维化和脂肪滴沉积。心脏功能的早期变化通常表现为舒张功能异常，随着时间的推移，舒张功能异常会导致收缩功能丧失。基于超声心动图的方法目前是诊断糖尿病心肌病的首选诊断方法，因为它具有广泛的应用和经济的使用。除了传统技术外，磁共振成像和光谱学以及造影剂现在正在引领心肌纤维化以及心脏和肝脏代谢变化的新诊断方法。这些策略可以与血清生物标志物相结合，以便即使在疾病的早期阶段，也能清楚地了解心脏结构/功能的糖尿病诱导变化。本文旨在综述目前可用于诊断糖尿病心肌病诱导的心脏结构/功能变化的实验和常规工具。这些工具可在糖尿病的实验模型中或临床应用中可靠地使用。
