Right ventricular dysfunction in type 1 diabetic cardiomyopathy: An overlooked component?

Figure 1 The role of right ventricle in diabetic cardiomyopathy induced by type 1 diabetes mellitus. Type 1 diabetes mellitus drives diabetic cardiomyopathy via pathways such as advanced glycation end products production, oxidative stress, and mitochondrial dysfunction. Pathological changes involve fibrosis, cardiac hypertrophy, and myocardial dysfunction. In diabetic cardiomyopathy: Left ventricle diastolic function deteriorates earliest (a potential early marker), while systolic function is most heavily studied (with left ventricular ejection fraction, as the most common assessment metric). Right ventricle (RV) is prognosis-relevant but often overlooked, and RV-pulmonary artery coupling requires functional evaluation. We emphasize three points: RV function’s critical role in prognosis (and need for inclusion in trial criteria/endpoints), the necessity for improved RV-pulmonary artery coupling markers, and the lack of drugs specifically targeting RV systolic/diastolic function. RV: Right ventricle; PA: Pulmonary artery; T1DM: Type 1 diabetes mellitus; AGEs: Advanced glycation end products; DCM: Diabetic cardiomyopathy; LV: Left ventricle; LVEF: Left ventricular ejection fraction; PAH: Pulmonary arterial hypertension.