TY - JOUR
T1 - Predisposing factors to heart failure in diabetic nephropathy
T2 - a look at the sympathetic nervous system hyperactivity
AU - Komici, Klara
AU - Femminella, Grazia Daniela
AU - de Lucia, Claudio
AU - Cannavo, Alessandro
AU - Bencivenga, Leonardo
AU - Corbi, Graziamaria
AU - Leosco, Dario
AU - Ferrara, Nicola
AU - Rengo, Giuseppe
PY - 2019/3
Y1 - 2019/3
N2 - Diabetes mellitus (DM) and heart failure (HF) are frequent comorbidities among elderly patients. HF, a leading cause of mortality and morbidity worldwide, is characterized by sympathetic nervous system hyperactivity. The prevalence of diabetes mellitus (DM) is rapidly growing and the risk of developing HF is higher among DM patients. DM is responsible for several macro- and micro-angiopathies that contribute to the development of coronary artery disease (CAD), peripheral artery disease, retinopathy, neuropathy and diabetic nephropathy (DN) as well. Independently of CAD, chronic kidney disease (CKD) and DM increase the risk of HF. Individuals with diabetic nephropathy are likely to present a distinct pathological condition, defined as diabetic cardiomyopathy, even in the absence of hypertension or CAD, whose pathogenesis is only partially known. However, several hypotheses have been proposed to explain the mechanism of diabetic cardiomyopathy: increased oxidative stress, altered substrate metabolism, mitochondrial dysfunction, activation of renin-angiotensin-aldosterone system (RAAS), insulin resistance, and autonomic dysfunction. In this review, we will focus on the involvement of sympathetic system hyperactivity in the diabetic nephropathy.
AB - Diabetes mellitus (DM) and heart failure (HF) are frequent comorbidities among elderly patients. HF, a leading cause of mortality and morbidity worldwide, is characterized by sympathetic nervous system hyperactivity. The prevalence of diabetes mellitus (DM) is rapidly growing and the risk of developing HF is higher among DM patients. DM is responsible for several macro- and micro-angiopathies that contribute to the development of coronary artery disease (CAD), peripheral artery disease, retinopathy, neuropathy and diabetic nephropathy (DN) as well. Independently of CAD, chronic kidney disease (CKD) and DM increase the risk of HF. Individuals with diabetic nephropathy are likely to present a distinct pathological condition, defined as diabetic cardiomyopathy, even in the absence of hypertension or CAD, whose pathogenesis is only partially known. However, several hypotheses have been proposed to explain the mechanism of diabetic cardiomyopathy: increased oxidative stress, altered substrate metabolism, mitochondrial dysfunction, activation of renin-angiotensin-aldosterone system (RAAS), insulin resistance, and autonomic dysfunction. In this review, we will focus on the involvement of sympathetic system hyperactivity in the diabetic nephropathy.
KW - Diabetic Cardiomyopathies/etiology
KW - Diabetic Nephropathies/complications
KW - Heart Failure/etiology
KW - Humans
KW - Sympathetic Nervous System/physiopathology
U2 - 10.1007/s40520-018-0973-2
DO - 10.1007/s40520-018-0973-2
M3 - Review article
C2 - 29858985
VL - 31
SP - 321
EP - 330
JO - Aging Clin. Exp. Res.
JF - Aging Clin. Exp. Res.
SN - 1594-0667
IS - 3
ER -