The sensitivity of the diabetic heart to ischemic injury depends on diabetes duration and severity, ischemic flow rate, and exogenous fatty acids, with increased vulnerability in prolonged diabetes.
Does diabetes alter the sensitivity of the heart to ischemic injury?
The sensitivity of the diabetic heart to ischemic injury is variable and depends on the duration and severity of diabetes, ischemic flow rate, and presence of exogenous fatty acids.
Clinical studies have suggested that the diabetic heart is more sensitive to ischemic injury than the non-diabetic heart. However, results from a number of experimental studies using animal models of diabetes reported no change, increased or decreased sensitivity to ischemia. The purpose of this review is to discuss the possible explanations for this apparent discrepancy. Analysis of the conflicting literature on this subject reveals a pattern which suggests that the disparity of experimental findings stems from differences in the duration and severity of the diabetic state, the ischemic flow rate and whether fatty acids are provided as an exogenous substrate. It appears that short-term or mild diabetes is associated with decreased sensitivity to zero-flow ischemic injury. However, as the duration or severity of diabetes increases, this beneficial effect disappears. The diabetic heart also appears to be more vulnerable to injury during low-flow ischemia and when elevated fatty acids are present.
D. J. Paulson (Tue,) conducted a review in Diabetes and ischemic injury. Diabetes vs. Non-diabetic state was evaluated on Sensitivity to ischemic injury. The sensitivity of the diabetic heart to ischemic injury depends on diabetes duration and severity, ischemic flow rate, and exogenous fatty acids, with increased vulnerability in prolonged diabetes.
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