Diabète et insuffisance cardiaque : la cardiomyopathie diabétique

Cardiovascular diseases are the first cause of mortality in patients with diabetes mellitus (DM). More specifically, the risk of heart failure is particularly increased in patients with DM because of the high prevalence of coronary artery disease and hypertension associated with DM, but also because of a specific cardiomyopathy called diabetic cardiomyopathy. Indeed, large epidemiological studies have shown that DM is an independent risk factor for heart failure. Those data are reinforced by several preclinical studies showing metabolic abnormalities, alterations of calcium homeostasis, or neurohormonal perturbations, in models of DM. Finally, at a very early stage, modifications of geometry and function of the left ventricle are frequently observed in asymptomatic patients with DM. As hypertensive cardiomyopathy exists, we now have a large amount of data in favor of the existence of a diabetic cardiomyopathy. In that perspective, this term recently entered in the guidelines of both the European Society of Cardiology and the American Heart Association.