Exercise mediated protection of diabetic heart through modulation of microRNA mediated molecular pathways.
Jason Kar Sheng LewJames T PearsonDaryl O SchwenkeRajesh G KatarePublished in: Cardiovascular diabetology (2017)
Hyperglycaemia, hypertension, dyslipidemia and insulin resistance collectively impact on the myocardium of people with diabetes, triggering molecular, structural and myocardial abnormalities. These have been suggested to aggravate oxidative stress, systemic inflammation, myocardial lipotoxicity and impaired myocardial substrate utilization. As a consequence, this leads to the development of a spectrum of cardiovascular diseases, which may include but not limited to coronary endothelial dysfunction, and left ventricular remodelling and dysfunction. Diabetic heart disease (DHD) is the term used to describe the presence of heart disease specifically in diabetic patients. Despite significant advances in medical research and long clinical history of anti-diabetic medications, the risk of heart failure in people with diabetes never declines. Interestingly, sustainable and long-term exercise regimen has emerged as an effective synergistic therapy to combat the cardiovascular complications in people with diabetes, although the precise molecular mechanism(s) underlying this protection remain unclear. This review provides an overview of the underlying mechanisms of hyperglycaemia- and insulin resistance-mediated DHD with a detailed discussion on the role of different intensities of exercise in mitigating these molecular alterations in diabetic heart. In particular, we provide the possible role of exercise on microRNAs, the key molecular regulators of several pathophysiological processes.
Keyphrases
- type diabetes
- left ventricular
- heart failure
- insulin resistance
- cardiovascular disease
- high intensity
- glycemic control
- oxidative stress
- physical activity
- wound healing
- resistance training
- adipose tissue
- pulmonary hypertension
- coronary artery disease
- cardiac resynchronization therapy
- aortic stenosis
- healthcare
- metabolic syndrome
- atrial fibrillation
- acute myocardial infarction
- single molecule
- high fat diet
- hypertrophic cardiomyopathy
- left atrial
- preterm infants
- stem cells
- skeletal muscle
- polycystic ovary syndrome
- coronary artery
- cell therapy
- transcatheter aortic valve replacement
- acute coronary syndrome
- signaling pathway
- percutaneous coronary intervention
- bone marrow
- gestational age
- heat shock