Diagnostic approaches for diabetic cardiomyopathy and myocardial fibrosis.
Diagnostic approaches for diabetic cardiomyopathy and myocardial fibrosis.
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DOI：
10.1016/j.yjmcc.2009.06.021
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发表时间：
2010-03
影响因子：
5
通讯作者：
Villarreal, Francisco J.
中科院分区：
文献类型：
--
作者：
Maya, Lisandro;Villarreal, Francisco J.
在糖尿病中，在没有缺血性心脏病、高血压或其他心脏病变的情况下，心脏结构/功能的改变称为糖尿病心肌病。在美国，糖尿病的患病率继续上升，目前该疾病影响到大约8%的总人口。因此，对糖尿病心肌病采用适当的诊断策略是非常必要的，这可能有助于在早期正确地识别疾病并实施适当的纠正治疗。目前，还没有单一的诊断方法来识别糖尿病心肌病。糖尿病心肌病可引起心脏结构的改变，如心肌肥大、纤维化和脂滴沉积。心脏功能的早期变化通常表现为舒张期功能异常，随着时间的推移会导致收缩功能的丧失。基于超声心动图的方法目前是糖尿病心肌病的首选诊断方法，因为它的广泛可获得性和经济使用。除了常规技术外，磁共振成像和光谱学以及造影剂现在正在引领诊断心肌纤维化以及心脏和肝脏代谢变化的新方法。这些策略可以与血清生物标记物相辅相成，因此即使在疾病的非常早期阶段，它们也可以为糖尿病引起的心脏结构/功能变化提供清晰的图景。本文拟对目前可用于诊断糖尿病心肌病所致心脏结构/功能改变的实验和常规工具进行综述。这些工具可以可靠地用于糖尿病的实验模型或临床应用。
In diabetes mellitus, alterations in cardiac structure/function in the absence of ischemic heart disease, hypertension or other cardiac pathologies is termed diabetic cardiomyopathy. In the United States, the prevalence of diabetes mellitus continues to rise and the disease currently affects about 8% of the general population. Hence, it is imperative the use of appropriate diagnostic strategies for diabetic cardiomyopathy, which may help correctly identify the disease at early stages and implement suitable corrective therapies. Currently, there is no single diagnostic method for the identification of diabetic cardiomyopathy. Diabetic cardiomyopathy is known to induce changes in cardiac structure such as, myocardial hypertrophy, fibrosis and fat droplet deposition. Early changes in cardiac function are typically manifested as abnormal diastolic function that with time leads to loss of contractile function. Echocardiography based methods currently stands as the preferred diagnostic approach for diabetic cardiomyopathy, due to its wide availability and economical use. In addition to conventional techniques, magnetic resonance imaging and spectroscopy along with contrast agents are now leading new approaches in the diagnosis of myocardial fibrosis, and cardiac and hepatic metabolic changes. These strategies can be complemented with serum biomarkers so they can offer a clear picture as to diabetes-induced changes in cardiac structure/function even at very early stages of the disease. This review article intends to provide a summary of experimental and routine tools currently available to diagnose diabetic cardiomyopathy induced changes in cardiac structure/function. These tools can be reliably used in either experimental models of diabetes or for clinical applications.
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