Patients with diabetes are at increased risk for heart failure, which may be a significant cause of morbidity and mortality. There is evidence of a diabetic cardiomyopathy that is independent of - but related to - other diabetic complications.


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)


To read more or access our algorithms and calculators, please log in or register.