The Pathogenesis of Myocardial Fibrosis in the Setting of Diabetic Cardiomyopathy
Open accessAbstract
Diabetes has emerged as a major threat to worldwide health. The increasing incidence of diabetes in young individuals is particularly worrisome given that the disease is likely to evolve over a period of years. In 1972, the existence of a diabetic cardiomyopathy was proposed based on the experience with four adult diabetic patients who suffered from congestive heart failure in the absence of discernible coronary artery disease, valvular or congenital heart disease, hypertension, or alcoholism. The exact mechanisms underlying the disease are unknown; however, an important component of the pathological alterations observed in these hearts includes the accumulation of extracellular matrix (ECM) proteins, in particular collagens. The excess deposition of ECM in the heart mirrors what occurs in other organs such as the kidney and peritoneum of diabetics. Mechanisms responsible for these alterations may include the excess production, reduced degradation, and/or chemical modification of ECM proteins. These effects may be the result of direct or indirect actions of high glucose concentrations. This article reviews our state of knowledge on the effects that diabetes-like conditions exert on the cells responsible for ECM production as well as relevant experimental and clinical data.
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The progression of DCM has been linked to cardiomyocyte hypertrophy and increased fibrosis.
“Structurally, the progression of DCM has been linked to cardiomyocyte hypertrophy and increased fibrosis [26-29].”
From Role of Serum Biomarkers in Early Detection of Diabetic Cardiomyopathy in the West Virginian Population (2016) · cites this paper as [26]
Hyperglycemia facilitates the reaction of glucose with collagen to form advanced glycation end-products (AGEs) that promote the crosslinking of collagen molecules to produce fibrosis.
“Hyperglycemia facilitates the reaction of glucose with collagen to form advanced glycation end-products (AGEs) that promote the crosslinking of collagen molecules to produce fibrosis [26].”
From Role of Serum Biomarkers in Early Detection of Diabetic Cardiomyopathy in the West Virginian Population (2016) · cites this paper as [26]
Diabetes-induced ROS generation up-regulates the expression of the profibrotic marker TGFβ, leading to increased extracellular matrix synthesis and fibrosis.
“Diabetes-induced ROS generation up-regulates the expression of the profibrotic marker TGFβ, leading to increased extracellular matrix synthesis and fibrosis [26].”
From Role of Serum Biomarkers in Early Detection of Diabetic Cardiomyopathy in the West Virginian Population (2016) · cites this paper as [26]
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“TGF-β levels correlate with the degree of cardiac fibrosis [26].”
Influential
- Authors
- Asbun, J., & Villarreal, F. J.
- Affiliations
- University of California San Diego (US)
- Corresponding author
- Villarreal, Francisco J.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2006-02
- Volume
- 47
- Issue
- 4
- Pages
- 693-700
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2012937324
- Cited by
- 486
- References
- 1
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 21 · 2023: 18 · 2022: 26 · 2021: 30 · 2020: 35 · 2019: 26 · 2018: 29 · 2017: 31 · 2016: 37 · 2015: 33 · 2014: 30 · 2013: 17 · 2012: 30
- FWCI
- 3.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- diabetic cardiomyopathy, myocardial fibrosis, extracellular matrix, collagen deposition, high glucose, fibroblasts, pathogenesis, congestive heart failure, diabetes mellitus
- MeSH terms
- Animals, Diabetes Mellitus, Experimental, Fibrosis, Humans, Hyperglycemia, Cardiomyopathies, Myocardium, Stress, Mechanical, Signal Transduction, Reactive Oxygen Species, Paracrine Communication, Diabetes Complications
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