Kakkar Chirag, Sharma Veerta, Mannan Ashi, Gupta Gaurav, Singh Sachin, Kumar Puneet, Dua Kamal, Kaur Amarjot, Singh Shareen, Dhiman Sonia, Singh Thakur Gurjeet
Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India.
Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, 346, United Arab Emirates.
Curr Cardiol Rev. 2025;21(2):88-107. doi: 10.2174/011573403X331870241025094307.
Diabetic Cardiomyopathy (DCM) is a notable consequence of diabetes mellitus, distinguished by cardiac dysfunction that occurs separately from coronary artery disease or hypertension. A recent study has revealed an intricate interaction of pathogenic processes that contribute to DCM. Important aspects involve the dysregulation of glucose metabolism, resulting in heightened oxidative stress and impaired mitochondrial function. In addition, persistent high blood sugar levels stimulate inflammatory pathways, which contribute to the development of heart fibrosis and remodelling. Additionally, changes in the way calcium is managed and the presence of insulin resistance are crucial factors in the formation and advancement of DCM. This may be due to the involvement of many molecular mechanistic pathways such as NLRP3, NF-κB, PKC, and MAPK with their downstream associated signaling pathways. Gaining a comprehensive understanding of these newly identified pathogenic pathways is crucial in order to design precise therapy approaches that can enhance the results for individuals suffering from diabetes. In addition, this review offers an in-depth review of not just pathogenic pathways and molecular mechanistic pathways but also diagnostic methods, treatment options, and clinical trials.
糖尿病性心肌病(DCM)是糖尿病的一个显著后果,其特征是心脏功能障碍,且独立于冠状动脉疾病或高血压之外发生。最近的一项研究揭示了导致DCM的致病过程之间的复杂相互作用。重要方面包括葡萄糖代谢失调,导致氧化应激增加和线粒体功能受损。此外,持续的高血糖水平会刺激炎症途径,这有助于心脏纤维化和重塑的发展。此外,钙管理方式的改变和胰岛素抵抗的存在是DCM形成和进展的关键因素。这可能是由于许多分子机制途径的参与,如NLRP3、NF-κB、PKC和MAPK及其下游相关信号通路。全面了解这些新发现的致病途径对于设计精确的治疗方法至关重要,这些方法可以提高糖尿病患者的治疗效果。此外,本综述不仅对致病途径和分子机制途径进行了深入综述,还对诊断方法、治疗选择和临床试验进行了深入综述。