Morphological characteristics in diabetic cardiomyopathy associated with autophagy

Diabetic cardiomyopathy, clinically diagnosed as ventricular dysfunction in the absence of coronary atherosclerosis or hypertension diabetic patients, is a cardiac muscle-specific disease that increases risk heart failure and mortality. Its clinical course characterized initially by diastolic dysfunction, later systolic eventually from an uncertain mechanism. Light microscopic features such interstitial fibrosis, inflammation, cardiomyocyte hypertrophy are observed but common to failing hearts generally not specific cardiomyopathy. Electron studies biopsy samples patients with have revealed essential mechanism underlying cardiomyopathy involves thickening capillary basement membrane, accumulation lipid droplets, glycogen well increased numbers autophagic vacuoles within cardiomyocytes. Autophagy conserved contributes maintaining intracellular homeostasis degrading long-lived proteins damaged organelles more often cardiomyocytes hearts. Diabetes mellitus (DM) impairs metabolism leads dysregulation energy substrates contribute autophagy. However, “snapshot” showing greater may indicate autophagy activated into phagophore formation suppressed due impairment lysosomal degradation step. Recent vivo shed light on molecular governing its meaning heart. Autophagic responses differ between types: they enhanced type 1 DM, 2 DM. This difference provides important insight pathophysiology Here, we review recent advances our understanding paying particular attention heart, discuss therapeutic potential interventions modulating