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2 型糖尿病相关心力衰竭:筛查、诊断与管理的最新观点。

Heart failure in type 2 diabetes: current perspectives on screening, diagnosis and management.

机构信息

IRCCS MultiMedica, Via Gaudenzio Fantoli, 16/15, 20138, Milan, Italy.

Faculty of Medicine, Clinical Center of Diabetes, Nutrition and Metabolic Diseases, Ovidius University of Constanta, Constanta, Romania.

出版信息

Cardiovasc Diabetol. 2021 Nov 6;20(1):218. doi: 10.1186/s12933-021-01408-1.

Abstract

Type 2 diabetes is one of the most relevant risk factors for heart failure, the prevalence of which is increasing worldwide. The aim of the review is to highlight the current perspectives of the pathophysiology of heart failure as it pertains to type 2 diabetes. This review summarizes the proposed mechanistic bases, explaining the myocardial damage induced by diabetes-related stressors and other risk factors, i.e., cardiomyopathy in type 2 diabetes. We highlight the complex pathology of individuals with type 2 diabetes, including the relationship with chronic kidney disease, metabolic alterations, and heart failure. We also discuss the current criteria used for heart failure diagnosis and the gold standard screening tools for individuals with type 2 diabetes. Currently approved pharmacological therapies with primary use in type 2 diabetes and heart failure, and the treatment-guiding role of NT-proBNP are also presented. Finally, the influence of the presence of type 2 diabetes as well as heart failure on COVID-19 severity is briefly discussed.

摘要

2 型糖尿病是心力衰竭最重要的相关危险因素之一,其患病率在全球范围内呈上升趋势。本综述旨在强调心力衰竭病理生理学的当前观点,因为它与 2 型糖尿病有关。本综述总结了拟议的机制基础,解释了与糖尿病相关应激源和其他危险因素相关的心肌损伤,即 2 型糖尿病心肌病。我们强调了 2 型糖尿病患者的复杂病理,包括与慢性肾脏病、代谢改变和心力衰竭的关系。我们还讨论了目前用于心力衰竭诊断的标准以及 2 型糖尿病患者的黄金标准筛查工具。目前批准的主要用于 2 型糖尿病和心力衰竭的药物治疗以及 NT-proBNP 的治疗指导作用也被提出。最后,简要讨论了 2 型糖尿病和心力衰竭对 COVID-19 严重程度的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c44f/8571838/89f31968503e/12933_2021_1408_Fig1_HTML.jpg

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