糖尿病性心肌病的细胞机制及基于药物的推荐治疗方案

Cellular mechanisms and recommended drug-based therapeutic options in diabetic cardiomyopathy.

作者信息

Dannenberg Lisa, Weske Sarah, Kelm Malte, Levkau Bodo, Polzin Amin

机构信息

Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty of the Heinrich Heine University Düsseldorf, Cardiovascular Research Institute Düsseldorf (CARID), Düsseldorf, Germany.

Institute of Molecular Medicine III, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Germany.

出版信息

Pharmacol Ther. 2021 Dec;228:107920. doi: 10.1016/j.pharmthera.2021.107920. Epub 2021 Jun 24.

DOI:10.1016/j.pharmthera.2021.107920

PMID:34171330

Abstract

Diabetes mellitus (DM) is associated with a specific cardiac phenotype characterized by structural and functional alterations. This so-called diabetic cardiomyopathy (DM CM) is clinically relevant as patients with DM show high incidence of heart failure. Mechanistically, several parameters interact on the cardiomyocyte level leading to increased inflammation, apoptosis, reactive oxygen species and altered calcium signaling. This in turn provokes functional myocardial changes that might inter alia play into the worsened clinical outcome in DM patients. Therefore, efficient therapeutic options are urgently needed. This review focuses on mechanistic effects of currently recommended antidiabetic treatment and heart failure therapy for DM CM.

摘要

糖尿病（DM）与一种以结构和功能改变为特征的特定心脏表型相关。这种所谓的糖尿病性心肌病（DM CM）在临床上具有相关性，因为糖尿病患者心力衰竭的发生率很高。从机制上讲，几个参数在心肌细胞水平上相互作用，导致炎症增加、细胞凋亡、活性氧生成以及钙信号改变。这反过来又引发了心肌功能的变化，这些变化尤其可能导致糖尿病患者临床结局恶化。因此，迫切需要有效的治疗选择。本综述重点关注目前推荐的抗糖尿病治疗和心力衰竭治疗对糖尿病性心肌病的机制性影响。