title: Diagnostic approaches for diabetic cardiomyopathy.
abstract: Diabetic cardiomyopathy (DCM) is a cardiac dysfunction which affects approximately 12% of diabetic patients, leading to overt heart failure and death. However, there is not an efficient and specific methodology for DCM diagnosis, possibly because molecular mechanisms are not fully elucidated, and it remains asymptomatic for many years. Also, DCM frequently coexists with other comorbidities such as hypertension, obesity, dyslipidemia, and vasculopathies. Thus, human DCM is not specifically identified after heart failure is established. In this sense, echocardiography has been traditionally considered the gold standard imaging test to evaluate the presence of cardiac dysfunction, although other techniques may cover earlier DCM detection by quantification of altered myocardial metabolism and strain. In this sense, Phase-Magnetic Resonance Imaging and 2D/3D-Speckle Tracking Echocardiography may potentially diagnose and stratify diabetic patients. Additionally, this information could be completed with a quantification of specific plasma biomarkers related to related to initial stages of the disease. Cardiotrophin-1, activin A, insulin-like growth factor binding protein-7 (IGFBP-7) and Heart fatty-acid binding protein have demonstrated a stable positive correlation with cardiac hypertrophy, contractibility and steatosis responses. Thus, we suggest a combination of minimally-invasive diagnosis tools for human DCM recognition based on imaging techniques and measurements of related plasma biomarkers.
authors.affiliation: Renal, Vascular and Diabetes Laboratory, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma, Av. Reyes Católicos 2, 28040, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Lorenzo-Almorós
authors.affiliation: Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Tuñón
authors.affiliation: Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Orejas
authors.affiliation: Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Cortés
authors.affiliation: Renal, Vascular and Diabetes Laboratory, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma, Av. Reyes Católicos 2, 28040, Madrid, Spain.|Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM) network, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Egido
authors.affiliation: Renal, Vascular and Diabetes Laboratory, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma, Av. Reyes Católicos 2, 28040, Madrid, Spain. olorenzo@fjd.es.|Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM) network, Madrid, Spain. olorenzo@fjd.es.
authors.forename: Ó
authors.identifier: 0000-0001-5515-6078
authors.initials: Ó
authors.lastname: Lorenzo
mesh_terms: D058065:Diabetic Cardiomyopathies / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
keywords: Biomarker; Diabetic cardiomyopathy; Diagnosis; Imaging