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European Journal of Heart Failure 2009 11(1):3-5; doi:10.1093/eurjhf/hfn033
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

The dialogue between diabetes and diastole

Loek van Heerebeek and Walter J. Paulus*

Department of Physiology, Institute for Cardiovascular Research, VU University Medical Center Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands

* Corresponding author. Tel: +31 20 4448110, Fax: +31 20 4448255, Email: wj.paulus@vumc.nl

This editorial refers to ‘A randomized trial of the impact of strict glycaemic control on myocardial diastolic function and perfusion reserve: a report from the DADD (Diabetes mellitus And Diastolic Dysfunction) study’{dagger} by Christina Jarnert et al. on page 39

The first 150 words of the full text of this article appear below.

Even in early reports, diabetic cardiomyopathy was related to hyperglycaemia-induced myocardial microvascular damage because of its association with glomerulosclerosis and retinopathy.1 Diabetic cardiomyopathy was initially classified as a dilated cardiomyopathy as it featured prominent left ventricular (LV) enlargement and depressed LV systolic function. Over the last decade, however, diastolic LV dysfunction was identified as an earlier manifestation of diabetic cardiomyopathy.2,3 This restrictive phenotype of diabetic cardiomyopathy was also related to hyperglycaemia. Impaired diastolic LV distensibility was thought to result from advanced glycation end products (AGEs) causing strong collagen cross-links in the myocardial extracellular matrix.4 Because of the presumed importance of hyperglycaemia in all clinical phenotypes of diabetic cardiomyopathy, it was speculated that strict glycaemic control, preferably with insulin, could retard or even reverse LV dysfunction in diabetic cardiomyopathy. The hypothesis of strict glycaemic control retarding or reversing diastolic LV dysfunction in patients with Type 2 diabetes mellitus was elegantly tested . . . [Full Text of this Article]


   DADD study design
 

   Hyperglycaemia: the sole perpetrator?
 

   ‘Le mieux est l'ennemi du bien’
 

   Funding
 

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Related articles in Eur J Heart Fail:

A randomized trial of the impact of strict glycaemic control on myocardial diastolic function and perfusion reserve: a report from the DADD (Diabetes mellitus And Diastolic Dysfunction) study
Christina Jarnert, Lena Landstedt-Hallin, Klas Malmberg, Anders Melcher, John Ohrvik, Hans Persson, and Lars Rydén
Eur J Heart Fail 2009 11: 39-47. [Abstract] [Full Text]