Diabetic heart disease: A clinical update

Figure 1 Pathophysiology of coronary artery disease in diabetes. AGE: Advanced glycation end products; RAGE: Receptors for AGE; LDL: Low density lipoprotein; ROS: Reactive oxygen species; PKC: Protein kinase C; HBP: Hexosamine biosynthetic pathway; MCP-1: Monocyte chemotactic pLrotein-1; VCAM-1: Vascular cell adhesion molecule 1; TGF-β: Transforming growth factor-β; ECM: Extracellular Matrix.

Figure 2 Pathophysiology of cardiac autonomic neuropathy in diabetes. PARP: Polyadenosine-diphosphate-ribose polymerase; AMPK: Adenosine monophosphate-activated protein kinase; ER: Endoplasmic reticulum; ROS: Reactive oxygen species; NADPH: Nicotinamide adenine dinucleotide phosphate; AGE: Advanced glycation end products; RAGE: Receptors for AGE; LDL: Low density lipoprotein; LCSFA: Long chain saturated fatty acid.

Figure 3 Pathophysiology of diabetic cardiomyopathy. NADPH: Nicotinamide adenine dinucleotide phosphate; ROS: Reactive oxygen species; GLUT: Glucose transporter; ER: Endoplasmic reticulum; SR: Sarcoplasmic reticulum; NF-kB: Nuclear factor-kB; TNF-α: Tumour necrosis factor-α; IL-6: Interleukin-6; IL-8: Interleukin-8; AGE: Advanced glycation end products; RAGE: Receptors for AGE; MHC: Myosin heavy chain; ANP: Atrial natriuretic peptide; BNP: Brain natriuretic peptide; TGF-β: Transforming growth factor-β; ECM: Extracellular matrix; NO: Nitric oxide; EDHF: Endothelium-derived hyperpolarising factor; ATP: Adenosine triphosphate; AP-1: Activator protein-1; BP: Blood pressure; DAG: Diacyl glycerol; FA: Fatty acid; CAN: Cardiac autonomic neuropathy; RAAS: Renin-angiotensin-aldosterone system.

Figure 4 Pathophysiology and clinical presentation of diabetic heart disease. AGE: Advanced glycation end products; RAGE: Receptors for AGE; HFpEF: Heart failure with preserved ejection fraction; HFrEF: Heart failure with reduced ejection fraction; CAN: Cardiac autonomic neuropathy; CAD: Coronary artery disease; DCM: Diabetic cardiomyopathy.