Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, 04100 Latina (LT), Italy.
Department of AngioCardioNeurology, IRCCS Neuromed, 86077 Pozzilli (IS), Italy.
Cardiovasc Res. 2017 Mar 15;113(4):378-388. doi: 10.1093/cvr/cvx011.
Heart failure is a highly morbid and mortal clinical condition that represents the last stage of most cardiovascular disorders. Diabetes is strongly associated with an increased incidence of heart failure and directly promotes cardiac hypertrophy, fibrosis, and apoptosis. These changes, in turn, contribute to the development of ventricular dysfunction. The clinical condition associated with the spectrum of cardiac abnormalities induced by diabetes is termed diabetic cardiomyopathy. Myocardial inflammation has recently emerged as a pathophysiological process contributing to cardiac hypertrophy, fibrosis, and dysfunction in cardiac diseases. Myocardial inflammation is also implicated in the development of diabetic cardiomyopathy. Several molecular mechanisms link diabetes to myocardial inflammation. The NF-κB signalling pathway and the renin-angiotensin-aldosterone system are strongly activated in the diabetic heart, thereby promoting myocardial inflammation. Advanced glycation end-products and damage-associated molecular pattern molecules also represent strong triggers for inflammation. The mediators resulting from this inflammatory process modulate specific intracellular signalling mechanisms in cardiac cells that promote the development of diabetic cardiomyopathy. This review article will provide an overview of the signalling molecular mechanisms linking diabetic cardiomyopathy to myocardial inflammation.
心力衰竭是一种高度病态和致命的临床状况,代表了大多数心血管疾病的终末阶段。糖尿病与心力衰竭发生率的增加密切相关,并直接促进心肌肥大、纤维化和细胞凋亡。这些变化反过来又导致心室功能障碍的发展。与糖尿病引起的心脏异常谱相关的临床状况称为糖尿病心肌病。心肌炎症最近已成为一种病理生理过程,可导致心脏疾病中的心肌肥大、纤维化和功能障碍。心肌炎症也与糖尿病心肌病的发展有关。有几种分子机制将糖尿病与心肌炎症联系起来。NF-κB 信号通路和肾素-血管紧张素-醛固酮系统在糖尿病心脏中被强烈激活,从而促进心肌炎症。晚期糖基化终产物和损伤相关分子模式分子也是炎症的强烈触发因素。这种炎症过程产生的介质调节心脏细胞中特定的细胞内信号机制,促进糖尿病心肌病的发展。本文综述了将糖尿病心肌病与心肌炎症联系起来的信号分子机制。
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