The complex phenotype of Diabetic Cardiomyopathy: clinical indicators and novel treatment targets

The complex phenotype of Diabetic Cardiomyopathy: clinical indicators and novel treatment targets PDF Author: Ramoji Kosuru
Publisher: Frontiers Media SA
ISBN: 283255542X
Category : Medical
Languages : en
Pages : 106

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Book Description
Diabetic cardiomyopathy is a clinical condition of heart dysfunction that develops in the absence of hypertension and coronary atherosclerosis in diabetic patients. The main characteristics of diabetic cardiomyopathy are myocardial fibrosis, cardiac stiffness, left ventricular hypertrophy and decreased left ventricular compliance. This eventually progresses to clinical heart failure with reduced ejection fraction. To detect changes in cardiac structure and function, such as fibrosis, several noninvasive techniques have been used. These include echocardiography, cinematic magnetic resonance imaging, and computed tomography. From a mechanistic perspective; oxidative stress, inflammation, enhanced production and deposition of advanced glycation end products (AGEs), mitochondrial dysfunction, impaired mitochondrial Ca2+ handling and function, and endoplasmic reticulum stress are observed. Furthermore activation of the sympathetic nervous system and renin-angiotensin system, microvascular dysfunction, and cardiac metabolic disorders are involved in the pathophysiology of this condition. Numerous proteins and signaling pathways, such as AMPK, FOXO1, SERCA2A, NF-kB, Nrf2, HO-1, MAPK, PKC, and PPARs, may be implicated in the development of diabetic cardiomyopathy. Additionally, increased levels of O-linked N-acetylglucosamine (O-GlcNAc), C-reactive protein, atrial natriuretic peptide, and, brain natriuretic peptide, among others, may also serve as clinical biomarkers to identify diabetic cardiomyopathy. Lifestyle modifications including aerobic exercise, maintaining a healthy weight, and smoking cessation are beneficial treatment measures to avoid diabetic cardiomyopathy. It is significant to note that in people with diabetes mellitus; high blood glucose and systemic and cardiac insulin resistance, are independently correlated to the development and progression of cardiac dysfunction and heart failure. The prevalence of diabetic cardiomyopathy declines with sustained glycemic management. However, a formal definition for diabetic cardiomyopathy as a distinct clinical entity remains poorly defined due to a lack of accepted diagnostic criteria and knowledge of subclinical cardiovascular diseases at the early stages of diabetes mellitus. There is currently no distinct histological features, biochemical markers, or clinical manifestation that can be used to make a definitive diagnosis of diabetic cardiomyopathy. Additionally, there are no prospective clinical trials to back up the claim that high insulin or blood sugar levels alone, without additional risk factors like obesity, coronary heart disease, or high blood pressure, increase the likelihood of developing diabetic cardiomyopathy. To decipher the precise mechanisms behind the onset and progression of diabetic cardiomyopathy, and to develop novel strategies for reducing the risk of heart failure in people with diabetes, further research is necessary. Hence, more clinical observational studies are required to comprehend the unknown factors underlying diabetic cardiomyopathy, and to further investigate novel biomarkers that can be used for risk assessment, screening, and diagnosis. Early detection and early intervention are essential for preventing diabetic cardiomyopathy, which drives ongoing research to better understand and treat this condition.

The complex phenotype of Diabetic Cardiomyopathy: clinical indicators and novel treatment targets

The complex phenotype of Diabetic Cardiomyopathy: clinical indicators and novel treatment targets PDF Author: Ramoji Kosuru
Publisher: Frontiers Media SA
ISBN: 283255542X
Category : Medical
Languages : en
Pages : 106

Get Book Here

Book Description
Diabetic cardiomyopathy is a clinical condition of heart dysfunction that develops in the absence of hypertension and coronary atherosclerosis in diabetic patients. The main characteristics of diabetic cardiomyopathy are myocardial fibrosis, cardiac stiffness, left ventricular hypertrophy and decreased left ventricular compliance. This eventually progresses to clinical heart failure with reduced ejection fraction. To detect changes in cardiac structure and function, such as fibrosis, several noninvasive techniques have been used. These include echocardiography, cinematic magnetic resonance imaging, and computed tomography. From a mechanistic perspective; oxidative stress, inflammation, enhanced production and deposition of advanced glycation end products (AGEs), mitochondrial dysfunction, impaired mitochondrial Ca2+ handling and function, and endoplasmic reticulum stress are observed. Furthermore activation of the sympathetic nervous system and renin-angiotensin system, microvascular dysfunction, and cardiac metabolic disorders are involved in the pathophysiology of this condition. Numerous proteins and signaling pathways, such as AMPK, FOXO1, SERCA2A, NF-kB, Nrf2, HO-1, MAPK, PKC, and PPARs, may be implicated in the development of diabetic cardiomyopathy. Additionally, increased levels of O-linked N-acetylglucosamine (O-GlcNAc), C-reactive protein, atrial natriuretic peptide, and, brain natriuretic peptide, among others, may also serve as clinical biomarkers to identify diabetic cardiomyopathy. Lifestyle modifications including aerobic exercise, maintaining a healthy weight, and smoking cessation are beneficial treatment measures to avoid diabetic cardiomyopathy. It is significant to note that in people with diabetes mellitus; high blood glucose and systemic and cardiac insulin resistance, are independently correlated to the development and progression of cardiac dysfunction and heart failure. The prevalence of diabetic cardiomyopathy declines with sustained glycemic management. However, a formal definition for diabetic cardiomyopathy as a distinct clinical entity remains poorly defined due to a lack of accepted diagnostic criteria and knowledge of subclinical cardiovascular diseases at the early stages of diabetes mellitus. There is currently no distinct histological features, biochemical markers, or clinical manifestation that can be used to make a definitive diagnosis of diabetic cardiomyopathy. Additionally, there are no prospective clinical trials to back up the claim that high insulin or blood sugar levels alone, without additional risk factors like obesity, coronary heart disease, or high blood pressure, increase the likelihood of developing diabetic cardiomyopathy. To decipher the precise mechanisms behind the onset and progression of diabetic cardiomyopathy, and to develop novel strategies for reducing the risk of heart failure in people with diabetes, further research is necessary. Hence, more clinical observational studies are required to comprehend the unknown factors underlying diabetic cardiomyopathy, and to further investigate novel biomarkers that can be used for risk assessment, screening, and diagnosis. Early detection and early intervention are essential for preventing diabetic cardiomyopathy, which drives ongoing research to better understand and treat this condition.

Diagnosis and Management of Hypertrophic Cardiomyopathy

Diagnosis and Management of Hypertrophic Cardiomyopathy PDF Author: Barry J. Maron
Publisher: John Wiley & Sons
ISBN: 140514615X
Category : Medical
Languages : en
Pages : 527

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Book Description
Diagnosis and Management of Hypertrophic Cardiomyopathy is aunique, multi-authored compendium of information regarding thecomplexities of clinical and genetic diagnosis, natural history,and management of hypertrophic cardiomyopathy (HCM)—the mostcommon and important of the genetic cardiovasculardiseases—as well as related issues impacting the health oftrained athletes. Edited by Dr. Barry J. Maron, a world authority on HCM, and withmajor contributions from all of the international experts in thisfield, this book provides a single comprehensive source ofinformation concerning HCM. Recent advances in the field arediscussed, including the importance of left ventricular outflowtract obstruction, the use of implantable defibrillators for theprevention of sudden death in young people, definition of thegenetic basis for HCM and its role in clinical diagnosis and riskstratification, the development of more precise strategies forassessing the level of risk for sudden death among all patientswith HCM, and the evolution of invasive interventions for heartfailure symptoms, such as surgical management and its alternatives(alcohol septal ablation and dual-chamber pacing). Key Features: Contributions from all experts in the field,representing diverse viewpoints regarding this heterogeneousdisease and related issues in athletes Information to dispel misunderstandings regarding issuesassociated with HCM and cardiovascular disease in athletes The only comprehensive source of information available on thetopic

Inflammation in Heart Failure

Inflammation in Heart Failure PDF Author: Matthijs Blankesteijn
Publisher: Academic Press
ISBN: 0128004851
Category : Medical
Languages : en
Pages : 221

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Book Description
Inflammation in Heart Failure, edited by W. Matthijs Blankesteijn and Raffaele Altara, is the first book in a decade to provide an in-depth assessment on the causes, symptoms, progression and treatments of cardiac inflammation and related conditions. This reference uses two decades of research to introduce new methods for identifying inflammatory benchmarks from early onset to chronic heart failure and specifically emphasizes the importance of classifying at-risk subgroups within large populations while determining the patterns of cytokines in such classifications. Further, the book details clinical applications of the pathophysiological mechanisms of heart failure, diagnosis and therapeutic strategies. Inflammation in Heart Failure's breadth of subject matter, easy-to-follow structure, portability, and high-quality illustrations create an accessible benefit for researchers, clinicians and students. - Presents updated information and research on the relevant inflammatory mediators of heart failure to aid in targeting future translational research as well as the improvement of early diagnosis and treatment - Provides research into better understanding the different inflammatory mediators that signal the underlying diseases that potentially lead to heart failure - Contains 20 years of research, offering a brief overview of the topic leading to current opinions on, and treatment of, heart failure - Provides a structured, systematic and balanced overview of the role of inflammation in heart failure making it a useful resource for researchers and clinicians, as well as those studying cardiovascular diseases

The Breathless Heart

The Breathless Heart PDF Author: Michele Emdin
Publisher: Springer
ISBN: 3319263544
Category : Medical
Languages : en
Pages : 288

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Book Description
This book systematically focuses on central sleep apneas, analyzing their relationship especially with heart failure and discussing recent research results and emerging treatment strategies based on feedback modulation. The opening chapters present historical background information on Cheyne-Stokes respiration (CSR), clarify terminology, and explain the mechanics and chemistry of respiration. Following a description of the physiology of respiration, the pathophysiology underlying central apneas in different disorders and particularly in heart failure is discussed. The similarities and differences of obstructive and central apneas are then considered. The book looks beyond the concept of sleep apnea to daytime CSR and periodic breathing during effort and contrasts the opposing views of CSR as a compensatory phenomenon or as detrimental to the failing heart. The diagnostic tools currently in use for the detection of CSR are thoroughly reviewed, with guidance on interpretation of findings. The book concludes by describing the various forms of treatment that are available for CSR and by explaining how to select patients for treatment.

Adrenal Disorders

Adrenal Disorders PDF Author: Andrew N. Margioris
Publisher: Springer Science & Business Media
ISBN: 1592591019
Category : Medical
Languages : en
Pages : 420

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Book Description
In Adrenal Disorders, a panel of distinguished physicians and researchers select the most relevant new findings and integrate them into the existing body of clinical knowledge on adrenal pathologies. The book includes important reviews of disturbances in cortisol homeostasis, and new concepts regarding adrenal tumors and hereditary adrenal diseases. Also discussed are mineralocorticoids and the syndromes of mineralocortoid excess and aldosterone synthase deficiency. Authoritative and insightful, Adrenal Disorders provides physicians and scientists with a comprehensive, state-of-the-art practical guide to the devastating diseases of the adrenals that are so often difficult to diagnose and treat.

Acute Heart Failure

Acute Heart Failure PDF Author: Alexandre Mebazaa
Publisher: Springer Science & Business Media
ISBN: 1846287820
Category : Medical
Languages : en
Pages : 922

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Book Description
For many years, there has been a great deal of work done on chronic congestive heart failure while acute heart failure has been considered a difficult to handle and hopeless syndrome. However, in recent years acute heart failure has become a growing area of study and this is the first book to cover extensively the diagnosis and management of this complex condition. The book reflects the considerable amounts of new data reported and many new concepts which have been proposed in the last 3-4 years looking at the epidemiology, diagnostic and treatment of acute heart failure.

The Chromosome 22q11.2 Deletion Syndrome

The Chromosome 22q11.2 Deletion Syndrome PDF Author: Donna M. McDonald-McGinn
Publisher: Academic Press
ISBN: 0128160489
Category : Medical
Languages : en
Pages : 526

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Book Description
The Chromosome 22q11.2 Deletion Syndrome: A Multidisciplinary Approach to Diagnosis and Treatment serves as the first comprehensive, user-friendly resource on the etiology, prognosis, and recurrence risk associated with the chromosome 22q11.2 deletion syndrome. Leading international contributors cover the background, genetics, testing methods, and pathophysiology of 22q11.2DS, placing emphasis on a strong foundation for multidisciplinary treatment strategies. Written by specialists in every applicable subspecialty, such as, cardiology, immunology, endocrinology, gastroenterology, hematology, ophthalmology, neurology, and psychiatry, among other fields. This book presents an authoritative resource with full color images that enhance concept illustration and aid in real-time decision-making. As 22q11.2 deletion syndrome has become a model for understanding rare and frequent anomalies, numerous medical issues, cognitive and behavioral phenotypes, and later onset conditions, this text will become the go to resource for clinicians, researchers, trainees, and motivated family members, in gaining a full understanding of this complex chromosomal disorder. - Provides a complete description of 22q11.2 deletion syndrome for healthcare professionals, researchers, trainees, and families affected by this common condition - Presents diagnostic and treatment strategies to help tackle this complex and often undiagnosed and therefore undertreated condition - Covered in a user-friendly, practical format that emphasizes evidence-based evaluation and treatment derived from the latest clinical experience and research in the field - Features leading international contributors in numerous sub-specialties, representing the multisystem nature of this condition - Includes full color figures, flow charts, tables, and patient images to guide real-time decision-making

Management of Genetic Syndromes

Management of Genetic Syndromes PDF Author: Suzanne B. Cassidy
Publisher: John Wiley & Sons
ISBN: 1118210670
Category : Medical
Languages : en
Pages : 1678

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Book Description
The bestselling guide to the medical management of common genetic syndromes —now fully revised and expanded A review in the American Journal of Medical Genetics heralded the first edition of Management of Genetic Syndromes as an "unparalleled collection of knowledge." Since publication of the first edition, improvements in the molecular diagnostic testing of genetic conditions have greatly facilitated the identification of affected individuals. This thorough revision of the critically acclaimed bestseller offers original insights into the medical management of sixty common genetic syndromes seen in children and adults, and incorporates new research findings and the latest advances in diagnosis and treatment of these disorders. Expanded to cover five new syndromes, this comprehensive new edition also features updates of chapters from the previous editions. Each chapter is written by an expert with extensive direct professional experience with that disorder and incorporates thoroughly updated material on new genetic findings, consensus diagnostic criteria, and management strategies. Edited by two of the field's most highly esteemed experts, this landmark volume provides: A precise reference of the physical manifestations of common genetic syndromes, clearly written for professionals and families Extensive updates, particularly in sections on diagnostic criteria and diagnostic testing, pathogenesis, and management A tried-and-tested, user-friendly format, with each chapter including information on incidence, etiology and pathogenesis, diagnostic criteria and testing, and differential diagnosis Up-to-date and well-written summaries of the manifestations followed by comprehensive management guidelines, with specific advice on evaluation and treatment for each system affected, including references to original studies and reviews A list of family support organizations and resources for professionals and families Management of Genetic Syndromes, Third Edition is a premier source to guide family physicians, pediatricians, internists, medical geneticists, and genetic counselors in the clinical evaluation and treatment of syndromes. It is also the reference of choice for ancillary health professionals, educators, and families of affected individuals looking to understand appropriate guidelines for the management of these disorders. From a review of the first edition: "An unparalleled collection of knowledge . . . unique, offering a gold mine of information." —American Journal of Medical Genetics

Cardiomyopathy

Cardiomyopathy PDF Author: Gustav Mattsson
Publisher:
ISBN: 9781789852240
Category : Myocardium
Languages : en
Pages : 0

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Book Description
Cardiomyopathies are diseases of the heart muscle with diverse etiologies ranging from myocarditis to gene mutations. They are classified according to morphology and function, and then further categorized based on whether they are familial or non-familial and based on specific etiologies. This book examines the various cardiomyopathies, including arrhythmogenic cardiomyopathy, hypertrophic cardiomyopathy, and dilated cardiomyopathy, as well as their genetic basis.

Registries for Evaluating Patient Outcomes

Registries for Evaluating Patient Outcomes PDF Author: Agency for Healthcare Research and Quality/AHRQ
Publisher: Government Printing Office
ISBN: 1587634333
Category : Medical
Languages : en
Pages : 385

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Book Description
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.