Abstract
Metabolic syndrome, diabetes, and ischemic heart disease are among the leading causes of death and disability in Western countries. Diabetic cardiomyopathy is responsible for the most severe signs and symptoms. An important strategy for reducing the incidence of cardiovascular disease is regular exercise. Remote ischemic conditioning has some similarity with exercise and can be induced by short periods of ischemia and reperfusion of a limb, and it can be performed in people who cannot exercise. There is abundant evidence that exercise is beneficial in diabetes and ischemic heart disease, but there is a need to elucidate the specific cardiovascular effects of emerging and unconventional forms of exercise in people with diabetes. In addition, remote ischemic conditioning may be considered among the options to induce beneficial effects in these patients. The characteristics and interactions of diabetes and ischemic heart disease, and the known effects of exercise and remote ischemic conditioning in the presence of metabolic syndrome and diabetes, are analyzed in this brief review.
Highlights
Diabetic cardiomyopathy and ischemic heart disease are among the leading causes of death and disability in Western countries
Fibrosis, which is the result of high deposition of extracellular matrix (ECM), leads to myocardial dysfunction, which compromises the relaxation of the left ventricle (LV) and hampers the efficiency of LV contraction
Diabetic cardiomyopathy is the consequence of the activation of multifactorial processes that lead to the damage of myocytes by alterations of numerous molecular pathways
Summary
Diabetic cardiomyopathy and ischemic heart disease are among the leading causes of death and disability in Western countries. Remote ischemic conditioning (RIC), using short periods of ischemia and reperfusion to a limb, due to the similarity with physical exercise, could be an alternative approach in people who cannot exercise. In this brief review, we analyze the characteristics and interactions of these two pathological conditions (diabetic cardiomyopathy and ischemic heart disease) and the known effects of exercise and remote conditioning in the presence of these diseases. The term “diabetic cardiomyopathy” was used for the first time in 1972 by Rubler et al [1] These authors have described this condition as a myocardial dysfunction in patients with diabetes in the absence of other heart diseases, including coronary artery disease and hypertension. The overload of substrates that provide energy and metabolic dysregulation, contributes, at least in part, to this metabolic form of cardiomyopathy [4,5,6]
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