国产超碰在线观看|91婷婷一二三区|免费中文视频在线|欧美一级日韩精品|影音AV二色在线|精品久久国产激情|美女网站黄色极品|青青草院视频在线|美女搞黄色无遮挡|青久在线手机视频

摘要糖尿病與心力衰竭之間的關(guān)系是復(fù)雜而雙向的。然而，完全可歸因于糖尿病的心肌病的存在由于缺乏共識等原因，它仍然是爭議的主題釋義在物理致病性研究結(jié)果方面也沒有達成一致意見需要存在于糖尿病心肌病的定義或其分類中，再加上缺乏針對這種疾病的診斷方法和治療方法，限制了它的一般理解。然而，對糖尿病心肌病的研究表明獨特的物理發(fā)病機制不同于其他疾病。同樣，新的治療方法已被證明在這種疾病中發(fā)揮潛在作用。以下綜述提供了有關(guān)的最新信息糖尿病性心肌病。

糖尿病Miocartiatía diabética恢復(fù)糖尿病和糖尿病的關(guān)系是一種復(fù)雜的疾病。

毫無疑問，糖尿病的預(yù)防和治療排斥性疾病的存在是引起爭議的原因。Esto es debido，entre otros動機，一種共識的定義。坦波科存在于los hallazgos fisiopatogénicos在分類中介紹了糖尿病患者。Esto，這是一個最新的診斷結(jié)果在這一過程中，限制了法律的普遍性。禁運，los estudios糖尿病患者的認知是不同的otras entidades。在管理不善的情況下，新的管理層將在紙上工作潛在的未來。在這一階段，我們將對實現(xiàn)糖尿病心肌梗死。

背景

盡管糖尿病與心力衰竭（HF）之間的關(guān)系已為人所知多年，但第一作者提及HF與糖尿病之間的顯著關(guān)聯(lián)1881.1 1954年，倫德貝克是第一個將糖尿病性心肌病（DCM）具體描述為

影響三分之二老年患者的心肌病患有糖尿病。2，3 1972年，魯布勒展示了尸檢擴張型心肌病與糖尿病的相關(guān)性糖尿病但無冠狀動脈疾病患者的其他疾病動脈疾病，射血分數(shù)降低的HF（HFrEF）以及在存在微血管并發(fā)癥的情況下。4由于那么，DCM有各種各樣的定義，5但是仍然缺乏普遍接受的標準條件。大多數(shù)定義都是基于臨床癥狀，并且需要在沒有其他條件的情況下DCM的診斷。某些定義要求不存在冠狀動脈疾病，6而其他人也需要沒有動脈高壓。7,8其他定義需要沒有其他心血管疾?。ù送夤跔顒用}疾病和動脈高血壓）如瓣膜性心臟病9，10和先天性心臟病11相比之下，其他作者提出的定義提到病理生理學(xué)標準，如心室擴張或肥大、間質(zhì)纖維化和舒張功能障礙。12，2018年，歐洲心臟病學(xué)學(xué)會13指出

沒有DCM的定義。因此，最廣泛的定義是指發(fā)生在沒有其他心血管疾病。7,8盡管如此，考慮到糖尿病，這個定義似乎不現(xiàn)實通常與其他心血管疾病共存，如動脈高血壓和缺血性心臟病。14為此因此，一些作者提出將DCM定義為心臟其他心血管疾病或非心血管疾病，可歸因于糖尿病15。

研究背景和問題：糖尿病心肌病可能是一個尚未充分了解的疾病，有關(guān)于其在糖尿病患者中導(dǎo)致心力衰竭的可疑關(guān)系。這個問題需密切關(guān)注，因為糖尿病是一個全球性問題，對此更好地理解可以開啟特定的治療方式，改善心衰患者的生活質(zhì)量。

研究方法和實驗設(shè)計：假設(shè)其采用了包括實驗室測試、動物模型、甚至可能的患者研究在內(nèi)的方法。選擇的方法應(yīng)該能有效研究糖尿病和心肌病之間的關(guān)系，例如通過檢查血糖控制和心肌損傷的程度之間的關(guān)聯(lián)。

研究結(jié)果和結(jié)論：結(jié)論可能會具有一些關(guān)于糖尿病怎樣和心肌病關(guān)聯(lián)的信息，可能會發(fā)現(xiàn)血糖水平控制不當可以加重心肌損傷。這個答案不僅有效地應(yīng)對了研究問題，而且如果牽涉到所有糖尿病患者，意義重大。

結(jié)果的限制：存在的限制可能包括樣本大小和選取，以及其他未考慮到的潛在影響因素，比如飲食、姿態(tài)、壓力等。是否能夠拓展到其他場景或人群取決于研究樣本的具體性。

研究意義和應(yīng)用價值：該研究對于糖尿病患者的治療以及預(yù)防心經(jīng)疾病非常重要。如果能通過控制血糖來防止或減緩心肌病的發(fā)展，那么這項研究可能會改變當前的糖尿病患者的管理模式。

1. Leyden E. Asthma and diabetes mellitus. Zeitschr Klin Med. 1881;3:358---64.

2. Lundbaek K. Diabetic angiopathy: a specific vascular disease. Lancet. 1954;266:377---9.

3. Lundbaek K. Is there a diabetic cardiopathy? Pathogenetische Fakt des Myokardinfarkts. 1969:63---71.

4. Rubler S, Dlugash J, Yuceoglu YZ, Kumral T, Branwood AW, Grishman A. New type of cardiomyopathy associated with dia

betic glomerulosclerosis. Am J Cardiol. 1972;30:595.

5. Lorenzo-Almorós A, Tunón J, Orejas M, Cortés M, Egido J, Lorenzo Ó. Diagnostic approaches for diabetic cardiomyopathy. Cardiovasc Diabetol. 2017;16:28.

6. Liu Q, Wang S, Cai L. Diabetic cardiomyopathy and its mechanisms: role of oxidative stress and damage. J Diabetes Investig. 2014;5:623---34.

7. Boudina S, Abel ED. Diabetic cardiomyopathy revisited. Circulation. 2007;115(25):32.

8. Rydén L, Grant PJ, Anker SD, Berne C, Cosentino F, Danchin N, et al. ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2013;34:3035---87.

9. Aneja A, Tang WH, Bansilal S, Garcia MJ, Farkouh ME. Diabetic cardiomyopathy: insights into pathogenesis, diagnostic challenges, and therapeutic options. Am J Med. 2008;121:748---57.

10. Tarquini R, Lazzeri C, Pala L, Rotella CM, Gensini GF. The diabetic cardiomyopathy. Acta Diabetol. 2011;48:173.

11. Matshela M. Second in a series on diabetes and the heart: diabetic cardiomyopathy ---- mechanisms and mode of diagnosis.E-Journal-of-Cardiology-Practice/Volume-14/Second-in-aseries-on-diabetes-and-the-heart-diabetic-cardiomyopathymechanisms-and-mode-of-diagnosis. E J Clin Pract ESC. 2016;14.

12. Voulgari C, Papadogiannis D, Tentolouris N. Diabetic cardiomyopathy: from the pathophysiology of the cardiac myocytes to current diagnosis and management strategies. Vasc Health Risk Manag. 2010;21:883---9.

13. Seferovi´c PM, Petrie MC, Filippatos GS, Anker SD, Rosano G, Bauersachs J, et al. Type 2 diabetes mellitus and heart failure: a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2018;20:853.

14. Ofstad AP. Myocardial dysfunction and cardiovascular disease in type 2 diabetes. Scand J Clin Lab Invest. 2016;76:271.

15. Lee MMY, McMurray JJV, Lorenzo-Almorós A, Kristensen SL, Sattar N, Jhund PS, et al. Diabetic cardiomyopathy. Heart

heartjnl-2. 2018;105:337---45.

16. Thrainsdottir IS, Aspelund T, Thorgeirsson G, Gudnason V, Hardarson T, Malmberg K, et al. The association between glucose abnormalities and heart failure in the population-based Reykjavik study. Diabetes Care. 2005;28:612.

17. McMurray J, Packer M, Desai AS, Gong J, Lefkowitz M, Rizkala AR, et al. Baseline characteristics and treatment of patients in prospective comparison of ARNI with ACEI to determineimpact on global mortality and morbidity in heart failure trial (PARADIGM-HF). Eur J Heart Fail. 2014;16:817---25.

18. Mcmurray JV, Östergren J, Swedberg PK, Granger CB, Held P, Michelson EL, et al. Effects of candesartan in patientswith

chronic heart failure and reduced left-ventricular systolicfunction taking angiotensin-converting-enzyme inhibitors: the

CHARM-Added trial. Lancet. 2003;362:767---71.

19. Bertoni AG, Tsai A, Kasper EK, Brancati FL. Diabetes and idiopathic cardiomyopathy: a nationwide case-control study.

Diabetes Care. 2003;26:279.

20. Nichols GA, Hillier TA, Erbey JR, Brown JB. Congestive heart failure in type 2 diabetes: prevalence, incidence, and risk factors. Diabetes Care. 2001;24:1614---9.

21. Sarma S, Mentz RJ, Kwasny MJ, Fought AJ, Huffman M, Subacius H, et al. Association between diabetes mellitus and postdischarge outcomes in patients hospitalized with heart failure:

findings from the EVEREST trial. Eur Heart J. 2013;15:194---202.

22. Kristensen SL, Mogensen UM, Jhund PS, Petrie MC, Preiss D, Win S, et al. Clinical and echocardiographic characteristics

and cardiovascular outcomes according to diabetes status in patients with heart failure and preserved ejection fraction:

a report from the I-preserve trial (Irbesartan in Heart Failure with preserved ejection. Circulation. 2017;135:724---35.

23. Bertoni AG, Hundley WG, Massing MW, Bonds DE, Burke GLGD. Heart failure prevalence, incidence, and mortality in the

elderly with diabetes. Diabetes Care. 2004;27:699.

24. Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and

microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321:405---12.

25. Dei Cas A, Fonarow GC, Gheorghiade MBJ. Concomitant diabetes mellitus and heart failure. Curr Probl Cardiol.

2015;40:7---43.

26. Maack C, Lehrke M, Backs J, Heinzel FR, Hulot JS, Marx N, et al. Heart failure and diabetes: metabolic alterations

and therapeutic interventions: a state-of-the-art review from the Translational Research Committee of the Heart Fail

ure Association-European Society of Cardiology. Eur Heart J. 2018;39:424.

27. Seferovi´c PMPW. Clinical diabetic cardiomyopathy: a twofaced disease with restrictive and dilated phenotypes. Eur

Heart J. 2015;36:171.

28. Ferrannini E, Mark MME. CV protection in the EMPA-REG OUTCOME trial: a ‘Thrifty Substrate’ hypothesis. Diabetes Care. 2016;39:e226.

29. Randle PJ, Garland PB, Hales CNNE. The glucose fatty-acid cycle. Its role in insulin sensitivity and the metabolic distur

bances of diabetes mellitus. Lancet. 1963;1:78.

30. Bertero EMC. Metabolic remodelling in heart failure. Nat Rev Cardiol. 2018;15:457.

31. Neubauer S. The failing heart ---- an engine out of fuel. N Engl J Med. 2007;356:11.

32. Bugger HAE. Molecular mechanisms of diabetic cardiomyopathy. Diabetologia. 2014;57:660.

33. Cadenas S. Mitochondrial uncoupling, ROS generation and cardioprotection. Biochim Biophys Acta Bioenerg. 2018;1859:94.

34. Lopaschuk GD, Ussher JR, Folmes CD, Jaswal JSSW. Myocardial fatty acid metabolism in health and disease. Physiol Rev. 2010;90:207.

35. Young ME, Patil S, Ying J, Depre C, Ahuja HS, Shipley GL, et al. Uncoupling protein 3 transcription is regulated by per

oxisome proliferator-activated receptor (alpha) in the adult rodent heart. FASEB J. 2001;15:833.

36. Cox PJ, Kirk T, Ashmore T, Willerton K, Evans R, Smith A, et al. Nutritional ketosis alters fuel preference and thereby

endurance performance in athletes. Cell metab. 2016;24:256.

37. Owen Oliver E. Ketone bodies as a fuel for the brain during starvation. Biochem Mol Biol Educ. 2005;33:246