This open access book presents a comprehensive overview of dilated cardiomyopathy, providing readers with practical guidelines for its clinical management. The first part of the book analyzes in detail the disease’s pathophysiology, its diagnostic work up as well as the prognostic stratification, and illustrates the role of genetics and gene-environment interaction. The second part presents current and future treatment options, highlighting the importance of long-term and individualized treatments and follow-up. Furthermore, it discusses open issues, such as the apparent healing phenomenon, the early prognosis of arrhythmic events or the use of genetic testing in clinical practice. Offering a multidisciplinary approach for optimizing the clinical management of DCM, this book is an invaluable aid not only for the clinical cardiologists, but for all physicians involved in the care of this challenging disease.

Diabetic cardiomyopathy is a clinical condition of heart dysfunction that develops in the absence of hypertension and coronary atherosclerosis in diabetic patients. The main characteristics of diabetic cardiomyopathy are myocardial fibrosis, cardiac stiffness, left ventricular hypertrophy and decreased left ventricular compliance. This eventually progresses to clinical heart failure with reduced ejection fraction. To detect changes in cardiac structure and function, such as fibrosis, several noninvasive techniques have been used. These include echocardiography, cinematic magnetic resonance imaging, and computed tomography. From a mechanistic perspective; oxidative stress, inflammation, enhanced production and deposition of advanced glycation end products (AGEs), mitochondrial dysfunction, impaired mitochondrial Ca2+ handling and function, and endoplasmic reticulum stress are observed. Furthermore activation of the sympathetic nervous system and renin-angiotensin system, microvascular dysfunction, and cardiac metabolic disorders are involved in the pathophysiology of this condition. Numerous proteins and signaling pathways, such as AMPK, FOXO1, SERCA2A, NF-kB, Nrf2, HO-1, MAPK, PKC, and PPARs, may be implicated in the development of diabetic cardiomyopathy. Additionally, increased levels of O-linked N-acetylglucosamine (O-GlcNAc), C-reactive protein, atrial natriuretic peptide, and, brain natriuretic peptide, among others, may also serve as clinical biomarkers to identify diabetic cardiomyopathy. Lifestyle modifications including aerobic exercise, maintaining a healthy weight, and smoking cessation are beneficial treatment measures to avoid diabetic cardiomyopathy. It is significant to note that in people with diabetes mellitus; high blood glucose and systemic and cardiac insulin resistance, are independently correlated to the development and progression of cardiac dysfunction and heart failure. The prevalence of diabetic cardiomyopathy declines with sustained glycemic management. However, a formal definition for diabetic cardiomyopathy as a distinct clinical entity remains poorly defined due to a lack of accepted diagnostic criteria and knowledge of subclinical cardiovascular diseases at the early stages of diabetes mellitus. There is currently no distinct histological features, biochemical markers, or clinical manifestation that can be used to make a definitive diagnosis of diabetic cardiomyopathy. Additionally, there are no prospective clinical trials to back up the claim that high insulin or blood sugar levels alone, without additional risk factors like obesity, coronary heart disease, or high blood pressure, increase the likelihood of developing diabetic cardiomyopathy. To decipher the precise mechanisms behind the onset and progression of diabetic cardiomyopathy, and to develop novel strategies for reducing the risk of heart failure in people with diabetes, further research is necessary. Hence, more clinical observational studies are required to comprehend the unknown factors underlying diabetic cardiomyopathy, and to further investigate novel biomarkers that can be used for risk assessment, screening, and diagnosis. Early detection and early intervention are essential for preventing diabetic cardiomyopathy, which drives ongoing research to better understand and treat this condition.

Inflammatory Heart Diseases presents comprehensive information on pericardial diseases, cardiomyopathies, and atherosclerotic cardiovascular diseases. Chapters are written by experts in the field and cover such topics as advanced concepts in pericardial disease, pericardial disease in the elderly, inflammation and diabetic cardiomyopathy, medical imaging in myocarditis, and the role of lifestyle in development of coronary heart disease, among others.

During the last years the understanding for the aetiology of cardiomyopathies could be greatly improved. A great deal of information has accumulated in the field of inherited metabolic diseases, which provides a new basis for our understanding of many heart muscle problems and their corresponding clinical disease entities. This book is meant to give the reader a comprehensive overview of the cardiological manifestations of inborn errors of metabolism. Latest information, such as cardiomyopathy in Fabry disease or in patients with CDG-syndrome is included. It should be helpful, not only to cardiologists, paediatricians, internists and general practicioners, but also to all those interested in a better understanding of the metabolic basis of clinical disease entities.

Diabetes has long been recognized as a disease of high blood sugar, and there has been a continuous search of the exact reason for its development and effective treatment. In 2005, the World Health Organization had estimated that more than 180 million people worldwide suffer from diabetes mellitus and indicated that this figure is likely to double within the next 20 years. Among the 3.8 million deaths each year associated with diabetes, about two thirds are attributable to cardiovascular complications, and diabetes is now considered to be a major metabolic risk factor for the occurrence of heart disease. Diabetic Cardiomyopathy: Biochemical and Molecular Mechanisms is a compilation of review articles devoted to the study on the topic with respect to biochemical and molecular mechanisms of hyperglycaemia. The wide range of areas covered here is of interest to basic research scientists, clinicians and graduate students, who are devoted to study the pathogenesis of diabetes-induced cardiovascular dysfunction. Furthermore, some chapters are directed towards increasing our understanding of novel ways for the prevention/treatment of cardiomyopathy. Twenty five articles in this book are organized in three sections. The first section discusses general aspects of the metabolic derangements in diabetic cardiomyopathy including metabolic alterations and substrate utilization as well as cardiac remodelling in the heart; role of diet in the development of metabolic syndrome in the heart; effect of hyperglycaemia in terms of biochemical and structural alterations in heart. In the second section, several cellular and molecular mechanisms are discussed indicating that diabetic cardiomyopathy is a multifactorial and complex problem. The third section discusses the prevention and treatment of diabetes using appropriate diet, proper supplements including antioxidants, angiotensin inhibitors and some other drugs. All in all, this book discusses the diverse mechanisms of diabetic cardiomyopathy with some information on new therapeutic approaches for finding solutions to prevent or reverse the development of cardiac dysfunction.

The heart is a strong muscular pump that enables tissue and organ perfusion. Therefore, a continuous supply of fresh blood is vital for cardiac function. In coronary artery disease, plaques or thrombi induce rapid occlusion, which restricts blood flow to the heart. The primary effect of coronary artery disease is substantial cardiomyocyte death, which prevents the heart from effectively pumping blood to vital organs.

In the past two decades a number of studies have shown that abnormalities in the function and structure of coronary microcirculation can be detected in several cardiovascular diseases. On the basis of the clinical setting in which it occurs, coronary microvascular dysfunction (CMD) can be classified into four types: CMD in the absence of any other cardiac disease; CMD in myocardial diseases; CMD in obstructive epicardial coronary artery disease; and iatrogenic CMD. In some instances CMD represents an epiphenomenon, whereas in others it represents an important marker of risk or may contribute to the pathogenesis of myocardial ischemia, thus becoming a possible therapeutic target. This book provides an update on coronary physiology and a systematic assessment of microvascular abnormalities in cardiovascular diseases, in the hope that it will assist clinicians in prevention, detection and management of CMD in their everyday activity.