Implications of Underlying Mechanisms for the Recognition and Management of Diabetic Cardiomyopathy
Open accessAbstract
Heart failure is a complex clinical syndrome, the incidence and prevalence of which is increased in diabetes mellitus, pre-diabetes, and obesity. Although this may arise from underlying coronary artery disease, it often occurs in the absence of significant major epicardial coronary disease, and most commonly manifests as heart failure with preserved ejection fraction. Despite epidemiological evidence linking diabetes to heart failure incidence and outcome, the presence of a distinct primary "diabetic" cardiomyopathy has been difficult to prove, because the link between diabetes and heart failure is confounded by hypertension, microvascular dysfunction, and autonomic neuropathy. Nonetheless, several mechanistic associations at systemic, cardiac, and cellular/molecular levels explain different aspects of myocardial dysfunction, including impaired cardiac relaxation, compliance, and contractility. This review seeks to describe recent advances and limitations pertinent to integrating molecular mechanisms, clinical screening, and potential therapeutic avenues for this condition.
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People with diabetes are at risk for developing structural heart disease and HFrEF in the absence of obstructive coronary artery disease.
“people with diabetes are at risk for developing structural heart disease and HFrEF in the absence of obstructive coronary artery disease (15).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [15]
The Epidemiology of Diabetes-Associated HF section reports increased heart-failure risk in people with diabetes, and the paper describes structural and functional myocardial abnormalities. It does not specifically establish that people with diabetes develop HFrEF in the absence of obstructive coronary artery disease; the epidemiology section says most published data do not distinguish HFrEF from HFpEF. Page numbers were not available in our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measuredPeople with diabetes are at risk for developing structural heart disease and HFrEF in the absence of obstructive coronary artery disease.
“In addition, people with diabetes are at risk for developing structural heart disease and HFrEF in the absence of obstructive coronary artery disease (14).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [14]
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The Diabetic Cardiomyopathy: The Contributing Pathophysiological Mechanisms
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- Authors
- Marwick, T. H., Ritchie, R., Shaw, J. E., & Kaye, D.
- Affiliations
- Baker Heart and Diabetes Institute (AU)
- Corresponding author
- Marwick, Thomas H.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2018-01
- Volume
- 71
- Issue
- 3
- Pages
- 339-351
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2783672601
- Cited by
- 365
- References
- 91
- Citations by year
- 2026: 29 · 2025: 40 · 2024: 56 · 2023: 52 · 2022: 46 · 2021: 51 · 2020: 45 · 2019: 31 · 2018: 15
- FWCI
- 6.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- AstraZeneca
- Sanofi
- Mylan
- Novo Nordisk
- State Government of Victoria
- Baker Heart and Diabetes Institute
- Medical Research Council
- National Health and Medical Research Council
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
- Keywords
- diabetic cardiomyopathy, heart failure with preserved ejection fraction, diabetes mellitus, cardiac dysfunction, myocardial relaxation, myocardial compliance, cardiac contractility, microvascular dysfunction, autonomic neuropathy, hypertension, molecular mechanisms, clinical screening, therapeutic target
- MeSH terms
- Diabetes Mellitus, Heart Failure, Humans, Disease Management, Diabetic Cardiomyopathies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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