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Insulin Resistance and Heart Failure
Open accessAbstract
Insulin resistance and associated reductions in cardiac insulin metabolic signaling is emerging as a major factor for the development of heart failure and assumes more importance because of an epidemic increase in obesity and the cardiorenal metabolic syndrome and our aging population. Major factors contributing to the development of cardiac insulin resistance are oxidative stress, hyperglycemia, hyperlipidemia, dysregulated secretion of adipokines/cytokines and inappropriate activation of renin-angiotensin II-aldosterone system (RAAS) and the sympathetic nervous system. The effects of cardiac insulin resistance are exacerbated by metabolic, endocrine and cytokine alterations associated with systemic insulin resistance. The aggregate of these various alterations leads to an insulin resistant phenotype with metabolic inflexibility, impaired calcium handling, mitochondrial dysfunction and oxidative stress, dysregulated myocardial-endothelial interactions resulting in energy deficiency, impaired diastolic dysfunction, myocardial cell death and cardiac fibrosis. Therefore, understanding the molecular mechanisms linking insulin resistance and heart failure may help to design new and more effective mechanism-based drugs to improve myocardial and systemic insulin resistance.
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Metadata
- Authors
- Aroor, A. R., Mandavia, C. H., & Sowers, J. R.
- Venue
- Heart Failure Clinics
- Publisher
- Elsevier BV
- Published
- 2012-10
- Volume
- 8
- Issue
- 4
- Pages
- 609-617
- ISSN
- 1551-7136 (ISSN-L)
- OpenAlex
- W67453287
- Cited by
- 252
- References
- 56
- FWCI
- 6.14
- Type
- journal article
- Language
- en
- Open access
- green
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