Entry
Name
Diabetic cardiomyopathy
Description
Diabetic cardiomyopathy has been defined as left ventricular dysfunction that occurs among patients with diabetes mellitus independent of a recognized cause such as coronary artery disease or hypertension. The pathogenesis of diabetic cardiomyopathy broadly involves hyperglycemia, increased circulating fatty acids, and insulin resistance contributing to reactive oxygen species (ROS) generation, mitochondrial dysfunction, impaired calcium metabolism, Renin-Angiotensin System (RAS) activation, and altered substrate metabolism. These effects result in cardiac fibrosis, hypertrophy, cardiomyocyte death, contractile dysfunction, endothelial cell damage and eventually heart failure. In the process of cardiac fibrosis, cardiac fibroblasts are the final effector cell.
Class
Human Diseases; Cardiovascular disease
BRITE hierarchy
Pathway map
Disease
H02498 Diabetic cardiomyopathy
Orthology
K00134 GAPDH, gapA; glyceraldehyde 3-phosphate dehydrogenase (phosphorylating) [EC:1.2.1.12 ]
K00161 PDHA; pyruvate dehydrogenase E1 component subunit alpha [EC:1.2.4.1 ]
K00162 PDHB; pyruvate dehydrogenase E1 component subunit beta [EC:1.2.4.1 ]
K00234 SDHA, SDH1; succinate dehydrogenase (ubiquinone) flavoprotein subunit [EC:1.3.5.1 ]
K00235 SDHB, SDH2; succinate dehydrogenase (ubiquinone) iron-sulfur subunit [EC:1.3.5.1 ]
K00236 SDHC, SDH3; succinate dehydrogenase (ubiquinone) cytochrome b560 subunit
K00237 SDHD, SDH4; succinate dehydrogenase (ubiquinone) membrane anchor subunit
K00411 UQCRFS1, RIP1, petA; ubiquinol-cytochrome c reductase iron-sulfur subunit [EC:7.1.1.8 ]
K00412 CYTB, petB; ubiquinol-cytochrome c reductase cytochrome b subunit
K00413 CYC1, CYT1, petC; ubiquinol-cytochrome c reductase cytochrome c1 subunit
K00414 QCR1, UQCRC1; ubiquinol-cytochrome c reductase core subunit 1
K00415 QCR2, UQCRC2; ubiquinol-cytochrome c reductase core subunit 2
K00416 QCR6, UQCRH; ubiquinol-cytochrome c reductase subunit 6
K00417 QCR7, UQCRB; ubiquinol-cytochrome c reductase subunit 7
K00418 QCR8, UQCRQ; ubiquinol-cytochrome c reductase subunit 8
K00419 QCR9, UCRC; ubiquinol-cytochrome c reductase subunit 9
K00420 QCR10, UQCR; ubiquinol-cytochrome c reductase subunit 10
K00820 glmS, GFPT; glutamine---fructose-6-phosphate transaminase (isomerizing) [EC:2.6.1.16 ]
K00922 PIK3CA_B_D; phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha/beta/delta [EC:2.7.1.153 ]
K02125 ATPeF08, MTATP8, ATP8; F-type H+-transporting ATPase subunit 8
K02126 ATPeF0A, MTATP6, ATP6; F-type H+-transporting ATPase subunit a
K02127 ATPeF0B, ATP5F1, ATP4; F-type H+-transporting ATPase subunit b
K02128 ATPeF0C, ATP5G, ATP9; F-type H+-transporting ATPase subunit c
K02131 ATPeF0F6, ATP5J; F-type H+-transporting ATPase subunit 6
K02132 ATPeF1A, ATP5A1, ATP1; F-type H+-transporting ATPase subunit alpha
K02133 ATPeF1B, ATP5B, ATP2; F-type H+-transporting ATPase subunit beta [EC:7.1.2.2 ]
K02134 ATPeF1D, ATP5D, ATP16; F-type H+-transporting ATPase subunit delta
K02135 ATPeF1E, ATP5E, ATP15; F-type H+-transporting ATPase subunit epsilon
K02136 ATPeF1G, ATP5C1, ATP3; F-type H+-transporting ATPase subunit gamma
K02137 ATPeF0O, ATP5O, ATP5; F-type H+-transporting ATPase subunit O
K02138 ATPeF0D, ATP5H, ATP7; F-type H+-transporting ATPase subunit d
K02261 COX2; cytochrome c oxidase subunit 2
K02262 COX3; cytochrome c oxidase subunit 3
K02263 COX4; cytochrome c oxidase subunit 4
K02264 COX5A; cytochrome c oxidase subunit 5a
K02265 COX5B; cytochrome c oxidase subunit 5b
K02266 COX6A; cytochrome c oxidase subunit 6a
K02267 COX6B; cytochrome c oxidase subunit 6b
K02268 COX6C; cytochrome c oxidase subunit 6c
K02270 COX7A; cytochrome c oxidase subunit 7a
K02271 COX7B; cytochrome c oxidase subunit 7b
K02272 COX7C; cytochrome c oxidase subunit 7c
K02273 COX8; cytochrome c oxidase subunit 8
K02580 NFKB1; nuclear factor NF-kappa-B p105 subunit
K02649 PIK3R1_2_3; phosphoinositide-3-kinase regulatory subunit alpha/beta/delta
K03882 ND4L; NADH-ubiquinone oxidoreductase chain 4L [EC:7.1.1.2 ]
K03934 NDUFS1; NADH dehydrogenase (ubiquinone) Fe-S protein 1 [EC:7.1.1.2 ]
K03935 NDUFS2; NADH dehydrogenase (ubiquinone) Fe-S protein 2 [EC:7.1.1.2 ]
K03936 NDUFS3; NADH dehydrogenase (ubiquinone) Fe-S protein 3 [EC:7.1.1.2 ]
K03937 NDUFS4; NADH dehydrogenase (ubiquinone) Fe-S protein 4
K03938 NDUFS5; NADH dehydrogenase (ubiquinone) Fe-S protein 5
K03939 NDUFS6; NADH dehydrogenase (ubiquinone) Fe-S protein 6
K03940 NDUFS7; NADH dehydrogenase (ubiquinone) Fe-S protein 7 [EC:7.1.1.2 ]
K03941 NDUFS8; NADH dehydrogenase (ubiquinone) Fe-S protein 8 [EC:7.1.1.2 ]
K03942 NDUFV1; NADH dehydrogenase (ubiquinone) flavoprotein 1 [EC:7.1.1.2 ]
K03943 NDUFV2; NADH dehydrogenase (ubiquinone) flavoprotein 2 [EC:7.1.1.2 ]
K03944 NDUFV3; NADH dehydrogenase (ubiquinone) flavoprotein 3
K03945 NDUFA1; NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 1
K03946 NDUFA2; NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 2
K03947 NDUFA3; NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 3
K03948 NDUFA4; NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 4
K03949 NDUFA5; NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 5
K03950 NDUFA6; NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 6
K03951 NDUFA7; NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 7
K03952 NDUFA8; NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 8
K03953 NDUFA9; NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 9
K03954 NDUFA10; NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 10
K03955 NDUFAB1; NADH dehydrogenase (ubiquinone) 1 alpha/beta subcomplex 1, acyl-carrier protein
K03956 NDUFA11; NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 11
K03957 NDUFB1; NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 1
K03958 NDUFB2; NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 2
K03959 NDUFB3; NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 3
K03960 NDUFB4; NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 4
K03961 NDUFB5; NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 5
K03962 NDUFB6; NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 6
K03963 NDUFB7; NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 7
K03964 NDUFB8; NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 8
K03965 NDUFB9; NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 9
K03966 NDUFB10; NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 10
K03967 NDUFC1; NADH dehydrogenase (ubiquinone) 1 subunit C1
K03968 NDUFC2; NADH dehydrogenase (ubiquinone) 1 subunit C2
K04166 AGTR1; angiotensin II receptor type 1
K04392 RAC1; Ras-related C3 botulinum toxin substrate 1
K04440 JNK; mitogen-activated protein kinase 8/9/10 (c-Jun N-terminal kinase) [EC:2.7.11.24 ]
K04500 SMAD2; mothers against decapentaplegic homolog 2
K04515 CAMK2; calcium/calmodulin-dependent protein kinase (CaM kinase) II [EC:2.7.11.17 ]
K04684 SP1; transcription factor Sp1
K04735 RELA; transcription factor p65
K04962 RYR2; ryanodine receptor 2
K05862 VDAC1; voltage-dependent anion channel protein 1
K05863 SLC25A4S, ANT; solute carrier family 25 (mitochondrial adenine nucleotide translocator), member 4/5/6/31
K06236 COL1A; collagen type I alpha
K06269 PPP1C; serine/threonine-protein phosphatase PP1 catalytic subunit [EC:3.1.3.16 ]
K07191 SLC2A4, GLUT4; MFS transporter, SP family, solute carrier family 2 (facilitated glucose transporter), member 4
K07203 MTOR, FRAP, TOR; serine/threonine-protein kinase mTOR [EC:2.7.11.1 ]
K07294 NR1C1, PPARA; peroxisome proliferator-activated receptor alpha
K07299 SLC2A1, GLUT1; MFS transporter, SP family, solute carrier family 2 (facilitated glucose transporter), member 1
K07860 RAC2; Ras-related C3 botulinum toxin substrate 2
K08009 CYBA, P22PHOX; cytochrome b-245, alpha polypeptide
K08010 NCF2, P67PHOX; neutrophil cytosolic factor 2
K08011 NCF1, P47PHOX; neutrophil cytosolic factor 1
K08012 NCF4, P40PHOX; neutrophil cytosolic factor 4
K09565 PPIF; peptidyl-prolyl isomerase F (cyclophilin D) [EC:5.2.1.8 ]
K09821 AGT, SERPINA8; angiotensinogen
K11351 NDUFB11; NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 11
K11352 NDUFA12; NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 12
K11353 NDUFA13; NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 13
K12044 TNNI3; troponin I, cardiac muscle
K13375 TGFB1; transforming growth factor beta-1
K13376 TGFB2; transforming growth factor beta-2
K13377 TGFB3; transforming growth factor beta-3
K15040 VDAC2; voltage-dependent anion channel protein 2
K15041 VDAC3; voltage-dependent anion channel protein 3
K16172 IRS1; insulin receptor substrate 1
K17605 PPP2R4, PTPA; serine/threonine-protein phosphatase 2A activator
K17902 TBC1D4, AS160; TBC1 domain family member 4
K19523 CPT1B; carnitine O-palmitoyltransferase 1, muscle isoform [EC:2.3.1.21 ]
K19720 COL3A; collagen type III alpha
K19722 AGER, RAGE; receptor for advanced glycosylation end products
K21421 NOX2, GP91, CYBB; NADPH oxidase 2 [EC:1.-.-.-]
K22138 MPC1; mitochondrial pyruvate carrier 1
K22139 MPC2; mitochondrial pyruvate carrier 2
K23605 SMAD3; mothers against decapentaplegic homolog 3
K24070 PARP1; poly [ADP-ribose] polymerase 1
Compound
C00043 UDP-N-acetyl-alpha-D-glucosamine
C00118 D-Glyceraldehyde 3-phosphate
C00236 3-Phospho-D-glyceroyl phosphate
C00352 D-Glucosamine 6-phosphate
C05981 Phosphatidylinositol-3,4,5-trisphosphate
C06156 alpha-D-Glucosamine 1-phosphate
C21011 [Protein]-N(epsilon)-(carboxymethyl)lysine
C21012 [Protein]-N(epsilon)-(carboxyethyl)lysine
Reference
Authors
Riehle C, Bauersachs J
Title
Of mice and men: models and mechanisms of diabetic cardiomyopathy.
Journal
Reference
Authors
Huynh K, Bernardo BC, McMullen JR, Ritchie RH
Title
Diabetic cardiomyopathy: mechanisms and new treatment strategies targeting antioxidant signaling pathways.
Journal
Reference
Authors
Lorenzo-Almoros A, Tunon J, Orejas M, Cortes M, Egido J, Lorenzo O
Title
Diagnostic approaches for diabetic cardiomyopathy.
Journal
Reference
Authors
Tan Y, Zhang Z, Zheng C, Wintergerst KA, Keller BB, Cai L
Title
Mechanisms of diabetic cardiomyopathy and potential therapeutic strategies: preclinical and clinical evidence.
Journal
Reference
Authors
Zamora M, Villena JA
Title
Contribution of Impaired Insulin Signaling to the Pathogenesis of Diabetic Cardiomyopathy.
Journal
Reference
Authors
Palomer X, Pizarro-Delgado J, Vazquez-Carrera M
Title
Emerging Actors in Diabetic Cardiomyopathy: Heartbreaker Biomarkers or Therapeutic Targets?
Journal
Reference
Authors
Mishra PK, Ying W, Nandi SS, Bandyopadhyay GK, Patel KK, Mahata SK
Title
Diabetic Cardiomyopathy: An Immunometabolic Perspective.
Journal
Reference
Authors
Chong CR, Clarke K, Levelt E
Title
Metabolic Remodeling in Diabetic Cardiomyopathy.
Journal
Reference
Authors
Brownlee M
Title
Biochemistry and molecular cell biology of diabetic complications.
Journal
Reference
Authors
Gollmer J, Zirlik A, Bugger H
Title
Established and Emerging Mechanisms of Diabetic Cardiomyopathy.
Journal
Reference
Authors
Boudina S, Abel ED
Title
Diabetic cardiomyopathy revisited.
Journal
Reference
Authors
Varma U, Koutsifeli P, Benson VL, Mellor KM, Delbridge LMD
Title
Molecular mechanisms of cardiac pathology in diabetes - Experimental insights.
Journal
Reference
Authors
Mandavia CH, Aroor AR, Demarco VG, Sowers JR
Title
Molecular and metabolic mechanisms of cardiac dysfunction in diabetes.
Journal
Reference
Authors
Falcao-Pires I, Leite-Moreira AF
Title
Diabetic cardiomyopathy: understanding the molecular and cellular basis to progress in diagnosis and treatment.
Journal
Reference
Authors
Westermeier F, Riquelme JA, Pavez M, Garrido V, Diaz A, Verdejo HE, Castro PF, Garcia L, Lavandero S
Title
New Molecular Insights of Insulin in Diabetic Cardiomyopathy.
Journal
Reference
Authors
Randhawa VK, Dhanvantari S, Connelly K
Title
How Diabetes and Heart Failure Modulate Each Other and Condition Management.
Journal
Reference
Authors
Athithan L, Gulsin GS, McCann GP, Levelt E
Title
Diabetic cardiomyopathy: Pathophysiology, theories and evidence to date.
Journal
Reference
Authors
Murarka S, Movahed MR
Title
Diabetic cardiomyopathy.
Journal
Reference
Authors
Thomas CM, Yong QC, Rosa RM, Seqqat R, Gopal S, Casarini DE, Jones WK, Gupta S, Baker KM, Kumar R
Title
Cardiac-specific suppression of NF-kappaB signaling prevents diabetic cardiomyopathy via inhibition of the renin-angiotensin system.
Journal
Reference
Authors
Brahma MK, Pepin ME, Wende AR
Title
My Sweetheart Is Broken: Role of Glucose in Diabetic Cardiomyopathy.
Journal
Reference
Authors
Singh VP, Le B, Khode R, Baker KM, Kumar R
Title
Intracellular angiotensin II production in diabetic rats is correlated with cardiomyocyte apoptosis, oxidative stress, and cardiac fibrosis.
Journal
Reference
Authors
Singh VP, Baker KM, Kumar R
Title
Activation of the intracellular renin-angiotensin system in cardiac fibroblasts by high glucose: role in extracellular matrix production.
Journal
Reference
Authors
Jia G, DeMarco VG, Sowers JR
Title
Insulin resistance and hyperinsulinaemia in diabetic cardiomyopathy.
Journal
Reference
Authors
Kim JA, Wei Y, Sowers JR
Title
Role of mitochondrial dysfunction in insulin resistance.
Journal
Reference
Authors
Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuniga FA
Title
Association between insulin resistance and the development of cardiovascular disease.
Journal
Reference
Authors
Evangelista I, Nuti R, Picchioni T, Dotta F, Palazzuoli A
Title
Molecular Dysfunction and Phenotypic Derangement in Diabetic Cardiomyopathy.
Journal
Reference
Authors
Joshi M, Kotha SR, Malireddy S, Selvaraju V, Satoskar AR, Palesty A, McFadden DW, Parinandi NL, Maulik N
Title
Conundrum of pathogenesis of diabetic cardiomyopathy: role of vascular endothelial dysfunction, reactive oxygen species, and mitochondria.
Journal
Reference
Authors
Knapp M, Tu X, Wu R
Title
Vascular endothelial dysfunction, a major mediator in diabetic cardiomyopathy.
Journal
Reference
Authors
Asbun J, Villarreal FJ
Title
The pathogenesis of myocardial fibrosis in the setting of diabetic cardiomyopathy.
Journal
Reference
Authors
Levick SP, Widiapradja A
Title
The Diabetic Cardiac Fibroblast: Mechanisms Underlying Phenotype and Function.
Journal
Related pathway
ko00010 Glycolysis / Gluconeogenesis
ko00520 Amino sugar and nucleotide sugar metabolism
ko04071 Sphingolipid signaling pathway
ko04933 AGE-RAGE signaling pathway in diabetic complications