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糖尿病心肌病:从机制到管理简述。

Diabetic Cardiomyopathy: From Mechanism to Management in a Nutshell.

机构信息

Department of Pathophysiology, Wuhan University School of Medicine, Hubei, Wuhan, China.

Department of Bioengineering, Faculty of Engineering, Integral University, Lucknow, India.

出版信息

Endocr Metab Immune Disord Drug Targets. 2021;21(2):268-281. doi: 10.2174/1871530320666200731174724.

Abstract

Diabetic cardiomyopathy (DCM) is a significant complication of diabetes mellitus characterized by gradually failing heart with detrimental cardiac remodelings, such as fibrosis and diastolic and systolic dysfunction, which is not directly attributable to coronary artery disease. Insulin resistance and resulting hyperglycemia is the main trigger involved in the initiation of diabetic cardiomyopathy. There is a constellation of many pathophysiological events, such as lipotoxicity, oxidative stress, inflammation, inappropriate activation of the renin-angiotensin-aldosterone system, dysfunctional immune modulation promoting increased rate of cardiac cell injury, apoptosis, and necrosis, which ultimately culminates into interstitial fibrosis, cardiac stiffness, diastolic dysfunction, initially, and later systolic dysfunction too. These events finally lead to clinical heart failure of DCM. Herein, The pathophysiology of DCM is briefly discussed. Furthermore, potential therapeutic strategies currently used for DCM are also briefly mentioned.

摘要

糖尿病性心肌病(DCM)是糖尿病的一种严重并发症,其特征为逐渐衰竭的心脏伴有有害的心脏重构,如纤维化和舒张及收缩功能障碍,但不能直接归因于冠状动脉疾病。胰岛素抵抗和由此导致的高血糖是引发糖尿病性心肌病的主要诱因。有一系列的许多病理生理事件,如脂毒性、氧化应激、炎症、肾素-血管紧张素-醛固酮系统的不适当激活、功能失调的免疫调节促进心脏细胞损伤、细胞凋亡和坏死的增加,最终导致间质纤维化、心脏僵硬、舒张功能障碍,最初,随后也出现收缩功能障碍。这些事件最终导致 DCM 的临床心力衰竭。在此,简要讨论 DCM 的病理生理学。此外,还简要提到了目前用于 DCM 的潜在治疗策略。

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