MOLECULAR AND GENETIC ASPECTS OF HEART FAILURE IN DIABETIC PATIENTS

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Abstract


This article deals with peculiarities of development and clinical course of heart failure (HF) in diabetic patients, influence of diabetic cardiopathy on HF formation., role of genetic predictors of diabetes mellitus (DM) and HF formation, also the importance of treatment response predictors, the significance of a more «personalized» exposure in order to optimize treatment. The role of stationary and dynamic genomics was analyzed,
especially molecular visualization that allows the earliest possible intervention. The article also includes examples of molecular visualization use in diagnosis of myocardial dysfunction, disease monitoring, and treatment efficacy assessment. Authors give an analysis of targeted treatment methods on the example of targeted delivery of medications to the target-organ (myocard). Discuss means of anti-ischemic myocardial protection, perspectives of metformin use in order to enhance efficacy of myocardial ischemic pre- and postconditioning mechanisms. Presented perspectives of study of molecular and genetic mechanisms involved in the pathogenesis of HF in diabetic patients, in particular, study of key biological features of stem cells, cell interactions, stem cell plasticity (in vitro direction of differentiation) and their paracrine function evaluation. Given information about identification of genes with partly altered expression due to chronic exposure of mesenchymal stem cells to the high concentration of glucose, and upon decreased ability of mesenchymal stem cells of proangiogenic factors with simultaneous increase of inflammatory markers production (IL8). In whole this article reviews modern state of HF in diabetic patients development mechanisms study with the use of molecular and genetic technologies, and of perspectives of development of this area.


About the authors

Е. V. Shlyakhto

Almazov Federal centre for heart, blood and endocrinology Ministry of Healthcare and Social development of Russia, St. Petersburg

Author for correspondence.
Email: shlyakhto@almazovcentre.ru

Russian Federation доктор медицинских наук, профессор, Заслуженный деятель науки РФ, ака- демик РАМН, директор ФГБУ «Федеральный центр сердца, крови и эндокринологии имени В.А. Алмазова» Минздравсоцразвития России Адрес: 197341, Санкт-Петербург, ул. Аккуратова, 2 Тел.: (812) 702-37-00; факс (812) 702-37-01

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