Hormonal
Hyperglycemia and insulin resistance drive Coronary Microvascular Dysfunction (CMD) through oxidative stress, inflammation, and reduced nitric oxide (NO) bioavailability, leading to endothelial dysfunction.
Controlling blood sugar and insulin resistance is critical not just for nerves and kidneys, but for heart health. High glucose and insulin resistance directly damage the heart's small blood vessels by creating oxidative stress and reducing the body's ability to dilate blood vessels (NO bioavailability).
The pathogenesis of this microvascular complication is complex and not completely known, involving several alterations among which hyperglycemia and insulin resistance play particularly central roles leading to oxidative stress, inflammatory activation and altered barrier function of endothelium.
Why this rating
Supported by extensive mechanistic data, animal models, and human studies cited throughout the review.
Source
Coronary Microvascular Dysfunction in Diabetes Mellitus: Pathogenetic Mechanisms and Potential Therapeutic Options
Teresa Salvatore et al. · Biomedicines · 2022
DOI 10.3390/biomedicines10092274
More from this paper
- Coronary Microvascular Dysfunction (CMD) is a significant predictor of adverse cardiovascular events, heart failure with preserved ejection fraction (HFpEF), and mortality in diabetic patients, even in the absence of obstructive coronary artery disease.Good
- GLP-1-based therapies and SGLT2 inhibitors provide protective effects on the coronary microvascular compartment in diabetic patients, addressing coronary microvascular dysfunction (CMD).Moderate
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