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Letter to the Editor
©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Dec 15, 2025; 16(12): 114485
Published online Dec 15, 2025. doi: 10.4239/wjd.v16.i12.114485
Beyond the left ventricle: Right ventricular dysfunction as a critical determinant in type 1 diabetes-related cardiomyopathy
Tong-Jian Zhao, Nian-Zhe Sun
Tong-Jian Zhao, Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, United States
Nian-Zhe Sun, National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
Nian-Zhe Sun, Department of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
Author contributions: Zhao TJ wrote the first draft, developed the main ideas, and led the revisions; Sun NZ provided critical feedback, improved the structure, and added key examples.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Nian-Zhe Sun, MD, National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha 410008, Hunan Province, China. sunnzh201921@sina.com
Received: September 22, 2025
Revised: October 21, 2025
Accepted: October 31, 2025
Published online: December 15, 2025
Processing time: 86 Days and 3 Hours
Core Tip

Core Tip: Yu et al conducted a rare longitudinal study of right ventricle (RV) and left ventricular function in type 1 diabetes. The left ventricle initially presented with diastolic dysfunction, followed by a decline in systolic function. Then, RV dysfunction emerged concurrently with the onset of pulmonary vascular pathologies and structural cardiac changes. These data align with clinical evidence that, although its onset is delayed, right heart failure independently predicts outcomes in diabetic patients. Recognizing RV failure as a component of diabetic cardiomyopathy is thus crucial, as it can facilitate earlier disease screening of diabetes, guide therapeutic strategies, and advance our understanding of biventricular remodeling.