Cardiac Dysfunction in the Diabetic Heart

Abstract

Chronic diabetics in general have a higher incidence of and mortality from cardiac disease (1). A wide spectrum of cardiac problems plague the chronic diabetic and include coronary artery disease, congestive heart failure and the newly recognized clinical entity, diabetic cardiomyopathy (2). Coronary artery disease has been recognized as one of the most common causes of death in middle-aged, non-insulin-dependent diabetics (3,4) and is estimated to be responsible for at least 40–50% of diabetic deaths (5). Autopsy studies comparing the frequency of coronary artery disease in diabetic and non-diabetics showed a prevalence rate ranging from 18 to 75% in diabetic patients (2,3). A number of epidemiologic studies reported on the prevalence and incidence of coronary artery disease in living diabetic populations during the follow-up periods. The University Group Diabetic Programme (UGDP) study indicated a prevalence rate of 9.5% and an incidence rate of 12% for coronary artery disease in diabetics over a period of 6.5 years (3). In the Framingham study, a prevalence rate of 1.6% and an incidence rate of 17% have been reported for coronary artery disease in the diabetic population (6,7). Similar data were obtained from various other population studies and led to the conclusion that the frequency of coronary artery disease in diabetics was about two and one-half times more than that in non-diabetics (4). These population studies have also shown that diabetes increases the risk for coronary artery disease in the female more than in the male (1,5).KeywordsAutonomic NeuropathyDiabetic CardiomyopathyDiabetic HeartSystolic Time IntervalSerum Free Fatty AcidThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.