Clinical features in diabetic cardiomyopathy:
(1) heart failure with dilated cardiomyopathy
(2) inability to explain the heart failure entirely because of:
(2a) hypertension
(2b) coronary artery disease
(2c) obesity
(2d) alcohol
(2e) other cause
The features of diabetic cardiomyopathy may be obscured if multiple comorbid conditions are present.
Diabetic cardiomyopathy may be due to some combination of:
(1) small vessel disease (microangiopathy)
(2) abnormalities in calcium signaling and transport
(3) myocyte hypertrophy and interstitial fibrosis
(4) oxidative stress
(5) advanced glycation end products (AGE)
(6) autonomic dysfunction
Risk factors for diabetic cardiomyopathy:
(1) longer duration of diabetes (5 years or more)
(2) poor diabetic control with chronic hyperglycemia
(3) other metabolic risk factors for cardiovascular disease (hyperlipidemia, smoking, etc)
