Rational Pharmacotherapy in Cardiology

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The mechanism of myocardial damage in diabetes mellitus is considered. The pathogenesis of myocardial fibrosis, leading to diabetic cardiomyopathy, is described in details. Management tactics aimed at the prevention of heart failure in patients with diabetes is proposed.

About the Authors

O. M. Drapkina
Sechenov First Moscow State Medical University
Russian Federation

B. B. Gegenava
Sechenov First Moscow State Medical University
Russian Federation


1. Bauters C, Lamblin N, McFadden EP, et al. Influence of diabetes mellitus on heart failure risk and outcome. Cardiovasc Diabetol 2003; 2:1–16.

2. Drapkina O. M., Kostyukevich M.V. The metabolic syndrome: the problem of the treatment of statin hepatotoxicity. Ateroskleroz i Dislipidemii 2011; 3: 43–46. Russian (Драпкина О. М., Костюкевич М.В. Метаболический синдром: проблема гепатотоксичности при лечении статинами. Атеросклероз и Дислипидемии 2011; 3: 43–46).

3. Ivashkin V.T., Drapkina O.M. The clinical significance of nitric oxide and heat shock proteins. Moscow: Geotar-Med; 2011. Russian (Ивашкин В.Т., Драпкина О.М. Клиническое значение оксида азота и белков теплового шока. М.: Геотар-Мед; 2011).

4. Verma S, Anderson TJ. The ten most commonly asked questions about endothelial function in cardiology. Cardiol Rev 2001;9:250–252.

5. Sarkar R, Meinberg EG, Stanley JC. et al. Nitric oxide reversibly inhibits the migration of cultured vascular smooth muscle cells. Circ Res 1996;78:225–230.

6. Kubes P, Suzuki M, Granger DN. Nitric oxide: an endogenous modulator of leukocyte adhesion. Proc Natl Acad Sci USA1991;88:4651–4655.

7. Williams SB, Cusco JA, Roddy MA. et al. Impaired nitric oxide-mediated vasodilation in patients with non-insulin-dependent diabetes mellitus. J Am Coll Cardiol 1996;27:567–574.

8. Johnstone MT, Creager SJ, Scales KM. et al. Impaired endothelium-dependent vasodilation in patients with insulin-dependent diabetes mellitus. Circulation 1993;88(6):2510–6.

9. De Vriese AS, Verbeuren TJ, Van de Voorde J. et al. Endothelial dysfunction in diabetes. Br J Pharmacol 2000;130:963–974.

10. Milstien S, Katusic Z. Oxidation of tetrahydrobiopterin by peroxynitrite. Biochem Biophys Res Commun 1999;263:681–684.

11. Hennes MM, O'Shaughnessy IM, Kelly TM. et al. Insulin-resistant lipolysis in abdominally obese hypertensive individuals. Hypertension 1996;28:120–126.

12. Tesfamariam B, Brown ML, Deykin D, Cohen RA. Elevated glucose promotes generation of endothelium-derived vasoconstrictor prostanoids in rabbit aorta. J Clin Invest 1990;85:929–932.

13. Hussain MJ, Peakman M, Gallati H. et al. Elevated serum levels of macrophage-derived cytokines precede and accompany the onset of IDDM. Diabetologia 1996;39:60–69.

14. Hopfner RL, Gopalakrishnan V. Endothelin: emerging role in diabetic vascular complications. Diabetologia 1999;42:1383–1394.

15. Christlieb AR, Janka HU, Kraus B. et al. Vascular reactivity to angiotensin II and to norepinephrine in diabetic subjects. Diabetes 1976;25:268–274.

16. Sawicki P.T. Beta blockers and diuretics: therapeutic drugs of first choice in diabetes mellitus and hypertension. Wien Klin Wochenschr 1995;107(21):629–39.

17. Bell DS. Diabetic cardiomyopathy: a unique entity or a complication of coronary artery disease? Diabetes Care 1995; 18:708–714.

18. Schannwell CM, Schneppenheim M, Perings S, et al. Left ventricular diastolic dysfunction as an early manifestation of diabetic cardiomyopathy. Cardiology 2002; 98:33–39

19. Di Bonito P, Cuomo S, Moio N, et al. Diastolic dysfunction in patients with non-insulin-dependent diabetes mellitus of short duration. Diabet Med1996; 13:321–324.

20. Beljic T, Miric M. Improved metabolic control does not reverse left ventricular filling abnormalities in newly diagnosed non-insulin-dependent diabetes patients. Acta Diabetol 1994; 31:147–150.

21. Nicolino A, Longobardi G, Furgi G, et al. Left ventricular diastolic filling in diabetes mellitus with and without hypertension. Am J Hypertens 1995; 8:382–389.

22. Redfield MM, Jcobsen SJ, Burnett JC, et al. Burden of systolic and diastolic ventricular dysfunction in the community. JAMA 2003; 289:194–202.

23. Poirier P, Bogaty P, Garneau C, et al. Diastolic dysfunction in normotensive men with well-controlled type 2 diabetes: importance of maneuvers in echocardiographic screening for preclinical diabetic cardiomyopathy. Diabetes Care 2001; 24:5–10.

24. Bertoni AG, Tsai A, Kasper EK, Francati FL. Diabetes and idiopathic cardiomyopathy: a nationwide casecontrol study. Diabetes Care 2003; 26:2791–2795.

25. Galderisi M, Anderson KM, Wilson PW, Levy D. Echocardiographic evidence for the existence of a distinct diabetic cardiomyopathy (the Framingham Heart Study). Am J Cardiol 1991; 68:85–89.

26. Struthers AD, Morris AD. Screening for and treating left-ventricular abnormalities in diabetes mellitus: a new way of reducing cardiac deaths. Lancet 2002; 359:1430–1432.

27. Phillips RA, Krakoff LR, Dunaif A, et al. Relation among left ventricular mass, insulin resistance, and blood pressure in nonobese subjects. J Clin Endocrinol Metab 1998; 83:4284–4288.

28. Shehadeh A, Regan TJ. Cardiac consequences of diabetes mellitus. Clin Cardiol 1995; 18:301–305.

29. Devereux RB, Roman MJ, Paranicas M, et al. Impact of diabetes on cardiac structure and function: the Strong Heart Study. Circulation 2000; 101:2271–2276.

30. Candido R, Forbes JM, Thomas MC, et al. A breaker of advanced glycation end products attenuates diabetes-induced myocardial structural changes. Circ Res 2003; 92:785–792.

31. Ziegelhoffer A, Ravingerova T, Styk J, et al. Mechanisms that may be involved in calcium tolerance of the diabetic heart. Mol Cell Biochem 1997; 176:191–198.

32. Wakasaki H, Koya D, Schoen FJ, et al. Targeted overexpression of protein kinase C beta2 isoform in myocardium causes cardiomyopathy. Proc Natl Acad Sci USA 1997; 94:9320–9325.

33. Young ME, McNulty P, Taegtmeyer H. Adaptation and maladaptation of the heart in diabetes. Part II. Potential mechanisms. Circulation 2002; 105:1861–1870.

34. Bell DS. Use of beta blockers in patients with diabetes. Endocrinologist 2003; 13:116–123.

35. Nuttila P, Hallsten K, Kirsi A, et al. Rosiglitazone but not metformin enhances insulin stimulated glucose uptake in patients with type 2 diabetes (Abstract). Diabetes 2002; 51 (Suppl 2):A142.

36. Zhou Y-T, Graburn P, Karim A, et al. Lipotoxic heart disease in obese rats: implications for human obesity. Proc Natl Acad Sci USA 2000; 97:1784–1789.

37. Kambara N, Holycross BJ, Wung P, et al. Combined effects of low-dose oral spironolactone and captopril therapy in a rat model of spontaneous hypertension and heart failure. J Cardiovasc Pharmacol 2003; 41:830–837.

38. Drapkina O.M. RAAS and fibrosis. Hepato-cardiac relations. Russkiy Meditsinskiy Zhurnal 2011;19(14):1–6. Russian (Драпкина О.М. РААС и фиброз. Гепатокардиальные связи. Русский Медицинский Журнал 2011;19(14):1–6).

39. Hunt SA Baker DN, Chin MH, et l, American College of Cardiology/American Heart Association: ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise 1995 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol 2001; 38:2101–2113.

40. Bell DS. Treatment of heart failure in patients with diabetes: clinical update. Ethn Dis 2002; 12:S1–S8.

41. Hagashi M, Tsutamoto T, Wada A, et al. Immediate administration of mineraldocorticoid receptor antagonist spironolactone prevents post-infarct left ventricular remodeling associated with suppression of a marker of myocardial collagen synthesis in patients with first anterior acute myocardial infarction. Circulation 2003; 107:2559–2565.

For citation:

Drapkina O.M., Gegenava B.B. MYOCARDIAL FIBROSIS IN PATIENTS WITH DIABETES MELLITUS. Rational Pharmacotherapy in Cardiology. 2013;9(1):62-65. (In Russ.)

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