Mechanisms of diabetic cardiomyopathy and potential therapeutic strategies: preclinical and clinical evidence.,Nature Reviews Cardiology

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Mechanisms of diabetic cardiomyopathy and potential therapeutic strategies: preclinical and clinical evidence.
Nature Reviews Cardiology ( IF 41.7 ) Pub Date : 2020-02-20 , DOI: 10.1038/s41569-020-0339-2
Yi Tan _{1,

2,

3} , Zhiguo Zhang ₄ , Chao Zheng ₅ , Kupper A Wintergerst _{1,

2,

6} , Bradley B Keller _{3,

7} , Lu Cai _{1,

2,

3,

8}

Affiliation

The pathogenesis and clinical features of diabetic cardiomyopathy have been well-studied in the past decade, but effective approaches to prevent and treat this disease are limited. Diabetic cardiomyopathy occurs as a result of the dysregulated glucose and lipid metabolism associated with diabetes mellitus, which leads to increased oxidative stress and the activation of multiple inflammatory pathways that mediate cellular and extracellular injury, pathological cardiac remodelling, and diastolic and systolic dysfunction. Preclinical studies in animal models of diabetes have identified multiple intracellular pathways involved in the pathogenesis of diabetic cardiomyopathy and potential cardioprotective strategies to prevent and treat the disease, including antifibrotic agents, anti-inflammatory agents and antioxidants. Some of these interventions have been tested in clinical trials and have shown favourable initial results. In this Review, we discuss the mechanisms underlying the development of diabetic cardiomyopathy and heart failure in type 1 and type 2 diabetes mellitus, and we summarize the evidence from preclinical and clinical studies that might provide guidance for the development of targeted strategies. We also highlight some of the novel pharmacological therapeutic strategies for the treatment and prevention of diabetic cardiomyopathy.

中文翻译：

糖尿病心肌病的机制和潜在的治疗策略：临床前和临床证据。

在过去的十年中，人们对糖尿病心肌病的发病机制和临床特征进行了深入的研究，但预防和治疗这种疾病的有效方法仍然有限。糖尿病心肌病是由与糖尿病相关的葡萄糖和脂质代谢失调引起的，导致氧化应激增加和介导细胞和细胞外损伤、病理性心脏重塑以及舒张和收缩功能障碍的多种炎症途径的激活。糖尿病动物模型的临床前研究已经确定了参与糖尿病心肌病发病机制的多种细胞内途径以及预防和治疗该疾病的潜在心脏保护策略，包括抗纤维化药物、抗炎药物和抗氧化剂。其中一些干预措施已经在临床试验中进行了测试，并显示出良好的初步结果。在这篇综述中，我们讨论了 1 型和 2 型糖尿病发生糖尿病心肌病和心力衰竭的机制，并总结了临床前和临床研究的证据，这些证据可能为制定针对性策略提供指导。我们还重点介绍了一些治疗和预防糖尿病心肌病的新型药物治疗策略。

更新日期：2020-02-20

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