Heart Failure And Type 2 Diabetes Mellitus: Neurohumoral, Histological And Molecular Interconnections

Area of Science:

• Cardiology
• Endocrinology
• Metabolic Diseases

Background:

• Heart failure (HF) poses a significant global health challenge, with Type 2 Diabetes Mellitus (T2DM) being a major risk factor exacerbating HF outcomes.
• Despite advances in understanding HF pathophysiology, hospitalization rates for patients with both HF and T2DM remain high, indicating unmet clinical needs.

Approach:

• This review synthesizes current knowledge on the intricate relationship between systemic neurohumoral factors and local cardiac processes in the context of T2DM.
• It focuses on key molecular and cellular mechanisms, including cardiomyocyte metabolism, mitochondrial function, calcium handling, hypertrophy, cell death, and extracellular matrix remodeling.

Key Points:

• T2DM adversely affects cardiomyocyte energy metabolism and mitochondrial function, impairing cardiac energetics.
• Dysregulated calcium handling in T2DM cardiomyocytes contributes to contractile dysfunction and cell death.
• T2DM promotes adverse myocardial remodeling through altered extracellular matrix dynamics, exacerbating HF progression.

Conclusions:

• Understanding the multifaceted interplay between T2DM and cardiac pathophysiology is crucial for developing targeted therapeutic strategies.
• Further research into the specific mechanisms discussed may lead to improved management and reduced cardiovascular events in patients with HF and T2DM.