An overview of the inflammatory signalling mechanisms in the myocardium underlying the development of diabetic cardiomyopathy

Giacomo Frati, Leonardo Schirone, Isotta Chimenti, Derek Yee, Giuseppe Biondi-Zoccai, Massimo Volpe, Sebastiano Sciarretta

Research output: Contribution to journalReview articlepeer-review

179 Scopus citations


Heart failure is a highly morbid and mortal clinical condition that represents the last stage of most cardiovascular disorders. Diabetes is strongly associated with an increased incidence of heart failure and directly promotes cardiac hypertrophy, fibrosis, and apoptosis. These changes, in turn, contribute to the development of ventricular dysfunction. The clinical condition associated with the spectrum of cardiac abnormalities induced by diabetes is termed diabetic cardiomyopathy. Myocardial inflammation has recently emerged as a pathophysiological process contributing to cardiac hypertrophy, fibrosis, and dysfunction in cardiac diseases. Myocardial inflammation is also implicated in the development of diabetic cardiomyopathy. Several molecular mechanisms link diabetes to myocardial inflammation. The NF-jB signalling pathway and the renin-angiotensin-aldosterone system are strongly activated in the diabetic heart, thereby promoting myocardial inflammation. Advanced glycation end-products and damage-associated molecular pattern molecules also represent strong triggers for inflammation. The mediators resulting from this inflammatory process modulate specific intracellular signalling mechanisms in cardiac cells that promote the development of diabetic cardiomyopathy. This review article will provide an overview of the signalling molecular mechanisms linking diabetic cardiomyopathy to myocardial inflammation.

Original languageEnglish
Pages (from-to)378-388
Number of pages11
JournalCardiovascular Research
Issue number4
StatePublished - Mar 15 2017


  • Cardiomyopathy
  • Cytokine
  • Diabetes
  • Heart failure
  • Inflammation


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