Akademik Veri Yönetim Sistemi
Diabetic Cardiomyopathy, Belma Turan and Naranjan S. Dh, Editör, Springer, London/Berlin , New York, ss.65-76, 2013
Diabetic cardiomyopathy, which is defined as cardiac disease independent of vascular complications, is considered one of the consequences of the altered metabolic milieu during diabetes. Constant requirement for energy in the form of ATP is fulfilled mainly by utilizing carbohydrates (glucose and lactate) and fatty acids in the heart. Only minor differences exist between species, and the healthy adult heart relies on the oxidation of fatty acids for ATP production. Utilization of energetic substrates depends on many factors and hormones play a major role in the process. Insulin deficiency, for example, affects the levels of circulating glucose as well as fatty acids and, most certainly, these alterations contribute to the utilization of these substrates. In the past few decades, adipose tissue-originated hormones, such as leptin and adiponectin with major effects on metabolism, have been identified. Not only the amounts of hormones or substrate supply but also subcellular modifications seem to determine the heart’s preference for certain substrates during physiological and pathological transitions. Among them, in diabetes, the preference of the heart changes, or perhaps the heart becomes obligated to adapt to dramatic shifts in hormones, substrate supply, and subcellular alterations. This chapter summarizes the contribution of energetic substrate metabolism to the development of diabetic cardiomyopathy.