Diabetic cardiomyopathy: a controversial entity.

@article{Karamitsos2008DiabeticCA,
  title={Diabetic cardiomyopathy: a controversial entity.},
  author={Theodoros D. Karamitsos and Apostolos Tsapas and Jayanth Ranjit Arnold},
  journal={European heart journal},
  year={2008},
  volume={29 4},
  pages={
          564; author reply 565
        }
}
We read with interest the study by Konduracka et al. , 1 which concludes that patients with long-term type 1 diabetes mellitus under intensive insulin treatment do not have echocardiographic, biochemical, or morphological signs of diabetic cardiomyopathy. However, as the authors admit, this is directly opposed to several previous studies which clearly show the presence of myocardial diastolic dysfunction in patients with type 1 diabetes, when compared with control subjects.2–4 Importantly, like… 
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Diabetic cardiomyopathy: a controversial entity: reply

The results were clearly owed to rather stringent inclusion criteria; a prerequisite condition for diagnosing/ruling out DC; all patients with microalbuminuria (with both normal and abnormal renal function) were excluded from the study.

Association of Cardiovascular Risk Factors and Myocardial Fibrosis With Early Cardiac Dysfunction in Type 1 Diabetes: The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study

Circumferential dysfunction was consistently associated with older age, male sex, smoking history, obesity, higher blood pressure, lower HDL cholesterol, and higher mean HbA1c, which is major factors related to early cardiac dysfunction in type 1 diabetes.

Ischemic Versus Non-Ischemic (Neurogenic) Myocardial Contractility Impairment in Acute Coronary Syndromes: Prevalence and Impact on Left Ventricular Systolic Function Recovery

Novel findings from this study are: NC may contribute to myocardial contractility impairment in 1 in every 4 first-time ACS patients, NC contribution to contractile impairment in ACS is blunted in diabetes or pre-diabetes, and LV systolic function recovery is better in patients with NC.

Incidence of Hospitalization for Heart Failure and Case-Fatality Among 3.25 Million People With and Without Diabetes Mellitus

The view that heart failure is an under-recognized and important complication in diabetes mellitus, particularly for type 1 disease is supported, despite falling incidence, particularly in type 1 Diabetes mellitus.

Study on active components of mulberry leaf for the prevention and treatment of cardiovascular complications of diabetes

Fibroblast growth factor-21 prevents diabetic cardiomyopathy via AMPK-mediated antioxidation and lipid-lowering effects in the heart

Results demonstrate that FGF21 functions physiologically and pharmacologically to prevent type 2 diabetic lipotoxicity-induced cardiomyopathy through activation of both AMPK–AKT2–NRF2-mediated antioxidative pathway and AM PK–ACC–CPT-1-mediated lipid-lowering effect in the heart.

DETECTION OF EARLY LEFT VENTRICULAR DYSFUNCTION IN TYPE 1 DIABETES MELLITUS BY STRAIN AND STRAIN RATE IMAGING

The presence of diabetes was an independent predictor of impairment of LV longitudinal strai n and strain rate and that give more sensitivity to strain and strain rates over conventional Doppler in earlier detection of systolic function.

References

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Diabetes-specific cardiomyopathy in type 1 diabetes mellitus: no evidence for its occurrence in the era of intensive insulin therapy.

Even the application of echocardiographic, biochemical and morphologic techniques hardly gives sufficient grounds to believe that type 1 diabetes alone may actually precipitate myocardial dysfunction, despite long-term course of the disease and typical histological changes in the myocardium.

Diabetes and the endocrine heart.

The study concludes that type 1 diabetes with modern insulin treatment (HBA1c = 7.5 ± 1.4%) is not associated with echocardiographic, biochemical, or morphological signs of diabetic …

Which Left Ventricular Function Is Impaired Earlier in the Evolution of Diabetic Cardiomyopathy?: An echocardiographic study of young type I diabetic patients

The findings indicate that myocardial damage in patients with diabetes affects diastolic function before systolic function, which is advisable for early detection of LV dysfunction before clinical symptoms appear, with follow-up to detect further deterioration of cardiac status.

Left Ventricular Diastolic Dysfunction as an Early Manifestation of Diabetic Cardiomyopathy

Investigating whether young patients with insulin-dependent diabetes mellitus and normal systolic left ventricular (LV) function already show a diastolic LV dysfunction and an increased risk of arrhythmias found echocardiography with measurements of diastolics functional parameters appears to be a sensitive method for evaluating the manifestation and course of early diabetic cardiomyopathy.

Left ventricular systolic and diastolic function in normotensive type 1 diabetic patients with or without autonomic neuropathy: a radionuclide ventriculography study.

At rest, DAN patients have impaired LV filling pattern, slightly increased LV systolic function, and a higher LV working load, in comparison to non-DAN type 1 diabetic patients.

Early diastolic impairment of diabetic heart: the significance of right ventricle.

Effect of lisinopril on progression of retinopathy in normotensive people with type 1 diabetes

Usefulness of colour tissue Doppler imaging in assessing aortic elastic properties in Type 1 diabetic patients

It is hypothesized that the change in aortic elastic properties could be investigated with colour tissue Doppler imaging (CTDI) in Type 1 diabetic patients and that these findings could be related to theAortic stiffness index.

Standards of Medical Care in Diabetes: Response to Power

The title “Standards of Medical Care in Diabetes” was chosen because in the view of the American Diabetes Association (ADA), the recommendations represent what the association considers the “standards” for the care of patients with diabetes.

Standards of medical care in diabetes.

These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care.