New progress of diabetic cardiomyopathy from clinical diagnosis to treatment

Diabetic cardiomyopathyv (DC) has been defined as progressing heart failing, which is presence of abnormal myocardial performance or structure remodeling, without hypertension, epicardial coronary artery disease, valvular disease or congenital heart disease. DC is described as a complicated distinct entity, composed of metabolism disorder, energy metabolism abnormality, lipid toxicity, advanced glycosylation end product formation, microcirculation dysfunction,endoplasmic reticulum stress, the activation of RAAS, cardiac autonomic neuropathy, and miRNA dysregulation. These factors interact with each other, and induce the presence of myocardium apoptosis, collagen deposition, matrix proliferation, fibrosis, microvascular lesions and coronary artery disease. With Doppler echocardiography, magnetic resonance imaging (MRI), radionuclide imaging, we can detect at early stages abnormal cardiac diastolic function parameters and/or structure remodeling in clinical practice. In addition to newer techniques, some biomarkers have been associated with DC. However, it has yet to reach consensus regarding therapy for DC. Therefore, further research is warranted.