Lombardi C, Spigoni V, Gorga E, Dei Cas A
Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Parma and AOU of Parma, Parma, Italy.
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Cardiology, University of Brescia, Brescia, Italy.
Herz. 2016 May;41(3):201-7. doi: 10.1007/s00059-016-4415-7.
Heart failure (HF) affects approximately 1-2 % of the adult population. Diabetes mellitus (DM) is one of the most frequent comorbidities in HF, portending a worse prognosis. DM is associated with an increased risk of artery disease, and consequently of post-ischemic HF, but it may also alter directly the myocardial structure and function. Insights into the pathophysiological mechanisms of diabetic cardiomyopathy have been provided by both experimental and clinical investigations. In recent years, it has emerged that the fibrotic process is a result of the convergence of multiple neurohormonal alterations in diabetic cardiomyopathy at the basis of disease progression and phenotype determination: HF with reduced or preserved ejection fraction. Therapies for HF and DM should demonstrate an improved prognosis and have a neutral effect on glucose homeostasis and the risk of HF development.
心力衰竭（HF）影响约1%-2%的成年人口。糖尿病（DM）是HF最常见的合并症之一，预示着更差的预后。DM与动脉疾病风险增加相关，进而与缺血后HF相关，但它也可能直接改变心肌结构和功能。实验和临床研究均提供了对糖尿病性心肌病病理生理机制的见解。近年来发现，纤维化过程是糖尿病性心肌病中多种神经激素改变共同作用的结果，是疾病进展和表型决定（射血分数降低或保留的HF）的基础。HF和DM的治疗应显示出预后改善，并且对葡萄糖稳态和HF发生风险具有中性影响。
