Khattab Elina, Kyriakou Michaelia, Leonidou Elena, Sokratous Stefanos, Mouzarou Angeliki, Myrianthefs Michael M, Kadoglou Nikolaos P E
Department of Cardiology, Nicosia General Hospital, 2029 Nicosia, Cyprus.
Department of Cardiology, Limassol General Hospital, 3304 Limassol, Cyprus.
Pharmaceuticals (Basel). 2025 Jan 20;18(1):134. doi: 10.3390/ph18010134.
Diabetes mellitus (DM) is a multifaceted disorder with a pandemic spread and a remarkable burden of cardiovascular mortality and morbidity. Diabetic cardiomyopathy (DBCM) has been increasingly recognized as the development of cardiac dysfunction, which is accompanied by heart failure (HF) symptoms in the absence of obvious reasons like ischemic heart disease, hypertension, or valvulopathies. Several pathophysiological mechanisms have been proposed, including metabolic disorders (e.g., glycation products), oxidative stress, low-grade inflammation, mitochondrial dysfunction, etc., which should guide the development of new therapeutic strategies. Up to now, HF treatment has not differed between patients with and without diabetes, which limits the expected benefits despite the high cardiovascular risk in the former group. However, DBCM patients may require different management, which prioritize anti-diabetic medications or testing other novel therapies. This review aims to appraise the challenges and prospectives of the individualized pharmaceutical therapy for DBCM.
糖尿病（DM）是一种多方面的疾病，呈全球流行趋势，给心血管疾病带来了显著的死亡率和发病率负担。糖尿病性心肌病（DBCM）越来越被认为是心脏功能障碍的一种表现，在没有缺血性心脏病、高血压或瓣膜病等明显病因的情况下，会伴有心力衰竭（HF）症状。人们提出了几种病理生理机制，包括代谢紊乱（如糖化产物）、氧化应激、低度炎症、线粒体功能障碍等，这些机制应为新治疗策略的开发提供指导。到目前为止，糖尿病患者和非糖尿病患者的心力衰竭治疗并无差异，尽管前一组患者心血管风险较高，但这限制了预期疗效。然而，DBCM患者可能需要不同的管理方式，优先考虑抗糖尿病药物或测试其他新型疗法。本综述旨在评估DBCM个体化药物治疗的挑战和前景。
