Structural changes in the myocardium during diabetes-induced cardiomyopathy
Structural changes in the myocardium during diabetes-induced cardiomyopathy
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DOI：
10.1007/s10741-013-9388-5
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发表时间：
2014-01-01
影响因子：
4.6
通讯作者：
Singh, Jaipaul
中科院分区：
文献类型：
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作者：
Adeghate, Ernest;Singh, Jaipaul
糖尿病（DM）是一种主要的代谢紊乱，目前影响全球超过2.5亿人。全世界每年花费近8000亿磅用于诊断、治疗和护理糖尿病患者。预计到2030年，DM将增加到3.5亿。如果不加管理，DM可导致许多长期并发症，包括微血管病和大血管病以及心力衰竭（HF）。大多数糖尿病患者通常死于糖尿病引起的冠状动脉疾病和心肌病引起的HF。冠状动脉疾病和心肌病通常是由高血压（HG）。本文综述了糖尿病引起的高血糖和高血糖引起的氧化应激对心肌和心肌细胞结构的影响。与对照心脏相比，HG和由此产生的氧化应激与显著的心肌肥大和纤维化相关。在超微结构水平上，心肌细胞受到慢性HG和随后的氧化应激显示肿胀的线粒体，线粒体数量减少和有缺陷的肌原纤维和闰盘。大量研究表明，1型和2型糖尿病引起的高血糖可引起心肌纤维化、心肌病变、心肌细胞肥大和肌原纤维紊乱。如果不治疗，所有这些结构变化最终可能导致HF。
Diabetes mellitus (DM) is a major metabolic disorder currently affecting over 250 million people globally. It costs the worldwide health services almost A 800 pound billion annually to diagnose, treat and care for patients with diabetes. DM is predicted to rise to 350 million by 2030. If left unmanaged, DM can lead to numerous long-term complications including micro- and macro-angiopathy and heart failure (HF). Most diabetics usually die as a result of HF resulting from diabetes-induced coronary artery disease and cardiomyopathy. Coronary artery disease and cardiomyopathy are normally preceded by hyperglycaemia (HG). This review examines the structural changes, which occur within the myocardium and cardiomyocytes during exposure of the heart to diabetes-induced HG and HG-induced oxidative stress. HG and the resulting oxidative stress are associated with marked myocardial hypertrophy and fibrosis compared to control heart. At the ultrastructural level, cardiomyocytes subjected to chronic HG and subsequent oxidative stress display swollen mitochondria, reduced mitochondrial number and defective myofibrils and intercalated discs. Evidence from many studies shows that both type 1 and type 2 diabetes-induced HG can cause myocardial fibrosis, mitochondriopathy, myocyte hypertrophy and deranged myofibrils. All of these structural changes may eventually result in HF if left untreated.