What is the clinical evidence from this study?

Study design: Case Report. Population: Dilated cardiomyopathy and diabetes mellitus (n=1).

What does this research mean for the field?

In patients with dilated cardiomyopathy and diabetes, prominent myocardial deposition of advanced glycation end products (AGEs) and oxidative stress markers occurs within pre-existing diffuse fibrosis, potentially accelerating myocardial stiffening. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To investigate the pathological contribution of advanced glycation end product (AGE) accumulation and oxidative stress to cardiac dysfunction in a patient with dilated cardiomyopathy and diabetes.

January 11, 2026CureusOpen Access

Diffuse Myocardial Injury With Diabetes-Related Advanced Glycation End Product Accumulation in Dilated Cardiomyopathy: Pathological Insights From an Autopsy Case

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Key result

Autopsy in diabetic DCM reveals prominent pentosidine and oxidative stress within diffuse myocardial fibrosis.

Why the study?

Pathological evidence directly demonstrating the contribution of advanced glycation end product accumulation to advanced cardiac dysfunction in human autopsy cases remains limited.

Key Points

To investigate the pathological contribution of advanced glycation end product (AGE) accumulation and oxidative stress to cardiac dysfunction in a patient with dilated cardiomyopathy and diabetes.
Autopsy evaluation of a Japanese man in his late 60s with idiopathic dilated cardiomyopathy, secondary pulmonary hypertension, and subsequent diabetes mellitus.
Histological and immunohistochemical examination of myocardial, pulmonary, renal, and hepatic tissues for fibrosis, pentosidine, 8-hydroxy-2'-deoxyguanosine (8-OHdG), and RAGE.
Gross cardiac examination showed marked cardiac enlargement with severe biventricular dilatation without ventricular wall hypertrophy.
Microscopic analysis revealed diffuse interstitial and perimyocytic fibrosis with transmural myocardial atrophy and pulmonary arterial fibrous intimal thickening.
Immunohistochemical staining demonstrated prominent myocardial deposition of pentosidine alongside elevated 8-OHdG expression and RAGE immunoreactivity within fibrotic myocardium.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

n=1 Japanese man in his late 60s with long-standing idiopathic dilated cardiomyopathy (diagnosed 13 years prior) who subsequently developed diabetes mellitus, progressive heart failure, and secondary pulmonary hypertension.

Outcome

Pathological and immunohistochemical findings of the heart, lungs, liver, and kidneys at autopsysurrogate

This autopsy case provides morphological evidence that diabetes-associated accumulation of advanced glycation end products (AGEs) may contribute to myocardial injury and functional deterioration in dilated cardiomyopathy.

Limitations

Descriptive nature of a single autopsy case
Absence of quantitative assessment
Lack of comparative control tissues such as non-diabetic dilated cardiomyopathy or age-matched normal myocardium
Incomplete access to long-term outpatient records including serial HbA1c measurements
descriptive nature of a single autopsy case
absence of quantitative assessment
absence of comparative control tissues
direct quantification of AGE burden and comparative vascular controls were not available

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Hypothesis-generating for AGEs in diabetic cardiomyopathy; prospective studies needed before clinical adoption.

Cite This Study

Kitazawa et al. (2026) conducted a case report in Dilated cardiomyopathy and diabetes mellitus (n=1). Autopsy analysis of a patient with dilated cardiomyopathy and diabetes demonstrated prominent myocardial deposition of pentosidine and oxidative stress markers within pre-existing diffuse fibrosis.

synapsesocial.com/papers/6a18c59284137bd80e91b9bc https://doi.org/10.7759/cureus.101298

Topics

Heart failure HFrEF treatment

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Diffuse Myocardial Injury With Diabetes-Related Advanced Glycation End Product Accumulation in Dilated Cardiomyopathy: Pathological Insights From an Autopsy Case

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Diffuse Myocardial Injury With Diabetes-Related Advanced Glycation End Product Accumulation in Dilated Cardiomyopathy: Pathological Insights From an Autopsy Case

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider