Diabetes and insulin resistance significantly increase the risk of post-myocardial infarction heart failure due to metabolic impacts on microvascular perfusion and myocardial energy generation.
Insulin resistance and hyperglycemia significantly impact microvascular perfusion and energy generation in the cardiac myocyte, contributing to the poor prognosis of heart failure in patients with diabetes after myocardial infarction.
Diabetes mellitus, the metabolic syndrome, and the underlying insulin resistance are increasingly associated with diastolic dysfunction and reduced stress tolerance. The poor prognosis associated with heart failure in patients with diabetes after myocardial infarction is likely attributable to many factors, important among which is the metabolic impact from insulin resistance and hyperglycemia on the regulation of microvascular perfusion and energy generation in the cardiac myocyte. This review summarizes epidemiologic, pathophysiologic, diagnostic, and therapeutic data related to diabetes and heart failure in acute myocardial infarction and discusses novel perceptions and strategies that hold promise for the future and deserve further investigation.
Bibra et al. (2011) conducted a review in Diabetes and postinfarction heart failure. Diabetes and insulin resistance significantly increase the risk of post-myocardial infarction heart failure due to metabolic impacts on microvascular perfusion and myocardial energy generation.