title: The limited clinical value of a specific diabetic cardiomyopathy.
abstract: OBJECTIVE
  Diabetic patients show a higher likelihood of developing heart failure (HF), independently of the atherosclerotic process, than their nondiabetic counterparts. This suggests the presence of an intrinsic vulnerability of the heart in patients with diabetes mellitus.
  
  
  RESULTS
  A cardiomyopathy specific to the diabetic patient was first hypothesized by Rubler and co-workers, in 1972 and recognized as a nosologic entity by the World Health Organization (WHO) in 1995. All patients falling under Rubler's definition had ascertained diabetic glomerusclerosis, but were unaffected by major coronary artery disease (CAD). Notably, the mean plasma glucose in those patients was 417 ± 209 mg/dl. Since then, several studies conducted in both animals and in humans have focused on pathogenetic mechanisms, clinical manifestations, diagnostic as well as therapeutic approaches utilized for the treatment of diabetic cardiomyopathy (DCM). Despite the large body of literature available, the clinical entity and significance of this diabetic complication continue to be elusive.
  
  
  CONCLUSIONS
  In the present report, recent pathophysiological findings and diagnostic strategies to treat DCM are reviewed. Particular attention is dedicated to the clinical manifestation of DCM, that is to heart failure (HF), and to the implications of co-morbidities and metabolic control on its evolution.
authors.affiliation: Department of Medicine DIMED, University of Padova, Via Giustiniani 2, 35128 Padova, Italy. saula.dekreutzenberg@unipd.it
authors.forename: S
authors.initials: S
authors.lastname: Vigili de Kreutzenberg
authors.forename: A
authors.initials: A
authors.lastname: Avogaro
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000032:analysis; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology; D058065:Diabetic Cardiomyopathies / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control; D004198:Disease Susceptibility; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control; D006973:Hypertension / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology
chemical_list: D001786:Blood Glucose