Nitric oxide synthases and diabetic cardiomyopathy

• Nitric oxide pathway is important for normal functioning of the heart.
• Its dyregulation contributes to various cardiovascular diseases including DCM.
• Potential role of epigenetic mechanisms in dysregulation of NOS pathway in DCM.
• Understanding regulation of NOS may help create effective therapeutics for DCM.

Cardiovascular complications associated with diabetes significantly contribute to high mortality and morbidity worldwide. The pathophysiology of diabetic cardiomyopathy (DCM), although extensively researched upon, is partially understood. Impairment in various signaling pathways including nitric oxide (NO) signaling has been implicated in the pathogenesis of diabetes induced myocardial damage. Nitric oxide synthases (NOS), the enzymes responsible for NO generation, play an important role in various physiological processes. Altered expression and activity of NOS have been implicated in cardiovascular diseases, however, the role of NOS and their regulation in the pathogenesis of DCM remain poorly understood. In the present review, we focus on the role of myocardial NOS in the development of DCM. Since epigenetic modifications play an important role in regulation of gene expression, this review also describes the epigenetic regulation of NOS.