Diabetic Cardiomyopathy by Belma Turan & Naranjan S. Dhalla

Author:Belma Turan & Naranjan S. Dhalla
Language: eng
Format: epub
Publisher: Springer New York, New York, NY

4 Conclusions

The electrocardiogram of diabetic patients often shows alterations that affect cardiac repolarization, especially a prolonged QTc associated with a higher risk of ventricular arrhythmias. Because the ECG is the result of the summation of the electric activity of each individual cardiac cell, the abnormalities observed in the electrocardiogram ultimately reflect alterations in either the activity or the amount of ionic channels in the membrane of the cardiomyocytes. Diabetes modifies inward and outward ionic currents in different ways. It is particularly relevant that the reduction in protein expression affects the channels responsible for the Ito and IKs currents. This reduction can be caused by a defective supply of trophic factors such as insulin or noradrenalin, as well as a reduction in channel protein synthesis secondary to the impaired metabolic status. Finally, diabetes also alters the currents by reducing the levels of regulatory proteins and second messengers, as is the case of the L-type Ca2+ current or the K+ current Ito, whose intracellular regulation by Ca2+ and kinases is impaired.

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