Key result
Metabolic maladaptation contributes to diabetic cardiomyopathy through mitochondrial dysfunction and increased fatty acid oxidation.
Why the study?
Altered cardiac metabolism in diabetic hearts leads to metabolic maladaptation, increasing vulnerability to ischemic insult and reducing adaptability compared to non-diabetic hearts.
Metabolic modulation targeting altered myocardial metabolism, such as with trimetazidine, may be beneficial for patients with diabetic cardiomyopathy.
Metabolic modulation may merit trials in diabetic cardiomyopathy; leaves open clinical benefits pending randomized evidence.
Altered cardiac metabolismWhy does this metabolic maladaptation in myocardium take place?There are many changes occur in micro and macro environment in the global scheme of metabolism is changed in the substrate influx in myocardium when free fatty acid availability is increased.Another significant alterations diabetic heart remains aberrant insulin signaling in myocardium leading to decreased glucose transporter (GLUT) mediated uptake. 2 Altered substrate influx with concomitant utilization of free fatty acid during stress and ischaemia makes diabetic heart more vulnerable to ischemic insult and other challenges.Thus altered metabolic status in diabetic heart makes it less adaptable to ischemia and cardiac events than non diabetic individuals.Given the metabolic alterations of the diabetic heart at rest and during episodes myocardial ischaemia, a therapeutic approach aimed at an improvement of cardiac metabolism through manipulations of the utilization of metabolic substrates should result in an improvement of myocardial ischaemia and of left ventricular function.Partial fatty acid oxidation in heart like Trimetazidine proves to be beneficial in clinical setting.Modulation of myocardial free fatty acid oxidation results reduced myocardial oxygen consumption resulting in a more happy and efficient heart.The metabolic modulation of altered myocardial metabolism in heart often renders to be helpful in T2DM patients and non diabetic cardiac patients, more so in the former cohorts. Diabetic cardiomyopathy due to metabolic maladaptation
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Pradip Kumar Mazumder (2022) conducted an editorial in Diabetic cardiomyopathy. Metabolic maladaptation in the diabetic heart, characterized by altered substrate influx, increased fatty acid oxidation, and mitochondrial dysfunction, contributes to diabetic cardiomyopathy.
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