Pathogenesis, Clinical Features and Treatment of Diabetic Cardiomyopathy
Pathogenesis, Clinical Features and Treatment of Diabetic Cardiomyopathy
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DOI：
10.1007/5584_2017_105
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发表时间：
2018-01-01
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影响因子：
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通讯作者：
Mauricio, Didac
中科院分区：
文献类型：
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作者：
Alonso, Nuria;Moliner, Pedro;Mauricio, Didac
1型和2型糖尿病（T1 D和T2 D）患者显示心力衰竭（HF）的发生率增加，即使在调整了明确的HF风险因素（如高血压和缺血性心脏病）后也是如此。由此产生的特定形式的心肌病被称为"糖尿病心肌病”（DCM）。DCM的致病机制可能是多因素的，从心肌代谢改变（高胰岛素血症、高胰岛素血症、循环脂肪酸和甘油三酯增加）到微血管疾病、自主神经病变和心肌结构改变伴纤维化。目前，科学协会对糖尿病（DM）患者HF的医学治疗建议与非DM患者没有差异。关于不同降糖药物对DM患者HF的影响，并考虑到现有最佳证据，钠-葡萄糖协同转运蛋白2抑制剂和二甲双胍似乎对T2 D和HF患者的影响特别有利。
Patients with type 1 and type 2 diabetes mellitus (T1D and T2D) show an increased incidence of heart failure (HF) even after adjustment for well established risk factors for HF such as hypertension and ischaemic heart disease. The resulting specific form of cardiomyopathy is known as diabetic cardiomyopathy" (DCM). Pathogenetic mechanisms underlying DCM are likely to be multifactorial, from altered myocardial metabolism (hyperglycaemia, hyperinsulinaemia, increased circulating fatty acids and trglycerides) to microvascular disease, autonomic neuropathy, and altered myocardial structure with fibrosis. Current medical treatment recommendations from scientific societies on HF in patients with diabetes mellitus (DM) do not differ from those for patients without DM. Regarding the effect of different hypoglycaemic drugs on HF in patients with DM, and considering the best available current evidence, the sodium-glucose-co-transporter 2 inhibitors and metformin seem to be especially advantageous regarding the effects in patients with T2D and HF.