Ludwig Boltzmann Institute for Cardiovascular Research at the Center for Biomedical Research, Medical University of Vienna, Vienna, Austria.
Ludwig Boltzmann Institute for Cardiovascular Research at the Center for Biomedical Research, Medical University of Vienna, Vienna, Austria -
Minerva Cardiol Angiol. 2022 Jun;70(3):385-392. doi: 10.23736/S2724-5683.21.05794-X. Epub 2021 Oct 29.
Diabetic patients are prone to suffer from cardiovascular disease, specifically from ischemic heart disease and diabetic cardiomyopathy, which have a huge impact on morbidity and mortality worldwide. Cardiac fibrosis due to alteration of the extracellular matrix (ECM) remodeling is often observed in diabetes and myocardial fibrosis is an important part of cardiac remodeling that leads to heart failure and death. At single-cell level, the ECM govern, metabolism, motility, orientation, and proliferation. However, in pathological condition such as diabetes, changes in ECM lead to fibrosis and subsequently cardiac stiffness and cardiomyocytes dysfunction. Antidiabetic drugs, particularly sodium-glucose cotransporter-2 (SGLT2) inhibitors have antifibrotic effects and may promote ECM reverse remodeling. In this review, the mechanisms, and the role of ECM remodeling and reverse remodeling as a potential therapeutic target for diabetic cardiomyopathy are discussed.
糖尿病患者易患心血管疾病，特别是缺血性心脏病和糖尿病心肌病，这对全球的发病率和死亡率有巨大影响。由于细胞外基质（ECM）重塑的改变，糖尿病患者常出现心脏纤维化，而心肌纤维化是导致心力衰竭和死亡的心脏重塑的重要组成部分。在单细胞水平上，ECM 控制着细胞的代谢、运动、定向和增殖。然而，在糖尿病等病理条件下，ECM 的变化会导致纤维化，进而导致心脏僵硬和心肌细胞功能障碍。抗糖尿病药物，特别是钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂具有抗纤维化作用，并可能促进 ECM 的逆转重塑。本综述讨论了 ECM 重塑和逆转重塑的机制及其作为糖尿病心肌病潜在治疗靶点的作用。
