Given the success of the previous collection,
The Complex Phenotype of Diabetic Cardiomyopathy: Clinical Indicators and Novel Treatment Targets, and new advances in the field, we are pleased to announce the launch of Volume II.
Diabetic cardiomyopathy is a clinical condition characterized by heart dysfunction that develops in diabetic patients in the absence of hypertension and coronary atherosclerosis. Key features include myocardial fibrosis, cardiac stiffness, left ventricular hypertrophy, and decreased left ventricular compliance, which eventually progress to heart failure with reduced ejection fraction. To detect changes in cardiac structure and function, such as fibrosis, various noninvasive techniques have been employed, including echocardiography, cinematic magnetic resonance imaging, and computed tomography.
Mechanistically, diabetic cardiomyopathy involves oxidative stress, inflammation, enhanced production and deposition of advanced glycation end products (AGEs), mitochondrial dysfunction, impaired mitochondrial Ca2+ handling, and endoplasmic reticulum stress. Additionally, activation of the sympathetic nervous system and the renin-angiotensin system, microvascular dysfunction, and cardiac metabolic disorders contribute to its pathophysiology. Numerous proteins and signaling pathways—such as AMPK, FOXO1, SERCA2A, NF-?B, Nrf2, HO-1, MAPK, PKC, and PPARs—may play key roles in the disease’s development. Clinical biomarkers like increased levels of O-linked N-acetylglucosamine (O-GlcNAc), C-reactive protein, atrial natriuretic peptide, and brain natriuretic peptide have also been implicated in identifying diabetic cardiomyopathy.
Lifestyle modifications, including aerobic exercise, maintaining a healthy weight, and smoking cessation, remain beneficial measures for preventing diabetic cardiomyopathy. High blood glucose levels and systemic and cardiac insulin resistance are strongly correlated with the development and progression of cardiac dysfunction and heart failure. Sustained glycemic management has been shown to reduce the prevalence of diabetic cardiomyopathy. However, a formal definition of diabetic cardiomyopathy as a distinct clinical entity is lacking, primarily due to the absence of widely accepted diagnostic criteria and knowledge of early-stage subclinical cardiovascular diseases. There are currently no distinct histological features, biochemical markers, or clinical manifestations for a definitive diagnosis. Moreover, there is insufficient evidence from prospective clinical trials to establish that high blood sugar or insulin levels alone—without additional risk factors like obesity, coronary heart disease, or hypertension—increase the likelihood of diabetic cardiomyopathy.
Further research is necessary to uncover the precise mechanisms behind the onset and progression of diabetic cardiomyopathy and to develop novel strategies to reduce the risk of heart failure in people with diabetes. Clinical observational studies are needed to identify unknown factors underlying diabetic cardiomyopathy, as well as to investigate novel biomarkers for risk assessment, screening, and diagnosis. Early detection and intervention are crucial to preventing diabetic cardiomyopathy, fueling ongoing research aimed at better understanding and treating this condition.
Cutting-edge methods that integrate multi-omics analyses—such as genomic, epigenetic, transcriptomic, proteomic, and metabolomic profiles—offer promising pathways for advancing this field. These high-throughput technologies can facilitate the development of a molecular framework for diabetic cardiomyopathy, enabling the identification of effective biomarkers and novel therapeutic targets. Ultimately, this approach may lead to precision medicine strategies that improve clinical outcomes for patients with diabetic cardiomyopathy.
The goal of this Research Topic is to highlight recent advances and discoveries in the progression and treatment of diabetic cardiomyopathy. We welcome submissions addressing, but not limited to, the following themes:
• Research progress on natural products and conventional drug therapies for diabetic cardiomyopathy
• Identification and validation of novel molecular biomarkers for the development and progression of diabetic cardiomyopathy
• Exploration of new therapeutic drug targets for diabetic cardiomyopathy
• Insights into cellular crosstalk in diabetic cardiomyopathy
• Metabolic complications and heart failure
We encourage the submission of original research, reviews, and other accepted article types.