CareView3D: structural changes and progression at the tissue level in diabetic heart failure

Seth Martin, MD, explains the structural changes that we see at the tissue level in patients with diabetic heart failure.

Transcript

00:00

So it's really interesting to dive into the structural changes that we see in terms of a progression at the tissue level in patients that have diabetic related heart failure.

00:13

What we see is that there's lipo-toxic injury, as well as metabolic stress that can drive cardiomyocyte hypertrophy

00:21

as well as fibrosis. Beyond the epicardial coronary disease that can happen in relation to diabetes and atherosclerosis,

00:28

there can be microvascular dysfunction in the smaller vessels that contributes to remodeling impaired compliance.

00:36

And this is seen in those heart failure phenotypes where we have preserved ejection fraction, so HFpEF,

00:42

but also in those patients with mildly reduced EFs. Cardiomyocyte hypertrophy, interstitial fibrosis,

00:49

and microvascular dysfunction converge to reduce myocardial compliance, impair ventricular filling,

00:56

and elevate filling pressures. The resulting HFpEF phenotype features thick walls, a small cavity, and preserved ejection fraction,

01:04

and represents the dominant pattern in patients with diabetes. This carries significant prognostic weight