ArticleCirculation2008
Diastolic stiffness of the failing diabetic heart: importance of fibrosis, advanced glycation end products, and myocyte resting tension.
Article in Circulation, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 320 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Influence of Liraglutide on Diastolic Cardiac Function and Myocardial Perfusion as Determined by Magnetic Resonance Imaging in Patients With Type 2 Diabetes: a Double-blind Randomized Parallel-group Trial
HbA1c as an Early Serologic Marker for the Hemodynamic Progression of Stage A Heart
Who cites it
320 citing papers in PubMed, 1 synthesis or guideline pooled it, 726 citations in OpenAlex.
- Impact of diabetes on outcomes in hypertrophic cardiomyopathy: a GRADE meta-analysis.Heart (British Cardiac Society) · 2026Pooled it
- Inflammatory signalling in diabetic cardiomyopathy: molecular mechanisms and potential therapeutic strategies.Nature reviews. Cardiology · 2026Review
- Mechanobiology of the diabetic cardiomyocyte: insulin signaling, titin elasticity, and multiscale mechanical dysfunction.Biophysical reviews · 2026Review
- Revisiting Glycemic Control Targets: Survival Outcomes by Glycated Hemoglobin Levels Among Patients With Diabetes Under Contemporary Antidiabetic Therapy.Journal of the American Heart Association · 2026Article
- Ghrelin protects against cell death in myocardial ischaemia: Emerging role of microRNA.Experimental physiology · 2026Article
- Intensive blood pressure control in heart failure with preserved ejection fraction: a symptom-modifying strategy.Heart failure reviews · 2026Review
- Metabolic dysfunction-associated steatotic liver disease and heart failure with preserved ejection fraction: A state-of-the-art review.World journal of cardiology · 2026Review
- Cardio-Vascular Extracellular Matrix: The Unmet Enigma.International journal of molecular sciences · 2026Review
- Role of Gut Microbiota in Diabetic HFpEF: Mechanisms and Therapeutic Implications.Diabetes, metabolic syndrome and obesity : targets and therapy · 2026Review
- Advanced glycation end products and RAGE signaling in diabetic cardiomyopathy: distinct mechanisms, human evidence, and translational barriers.Frontiers in cardiovascular medicine · 2026Review
- Effects of polycystic ovary syndrome on liver, heart, muscle, and pancreatic-related diseases.Frontiers in endocrinology · 2026Review
- Current diagnostic modalities for detecting myocardial relaxation function in diabetes-associated heart failure or heart failure with preserved ejection fraction.Current opinion in physiology · 2025Article
- Heart failure with preserved ejection fraction, from pathophysiology to technology tools aim improve patients' management.Heart failure reviews · 2025Review
- The Contribution of Echocardiography to the Diagnosis and Prognosis Stratification of Diabetic Cardiomyopathy.Diagnostics (Basel, Switzerland) · 2025Review
- What Is Cardiometabolic HFpEF and How Can We Study it Preclinically?JACC. Basic to translational science · 2025Review
- Advanced Glycation End-Product Carboxymethyl-Lysine and Incident Heart Failure and Atrial Fibrillation in Older Adults.Journal of the American Heart Association · 2025Article
- The heart of diabetes: unraveling metabolic drivers of cardiomyopathy.Cardiovascular diabetology. Endocrinology reports · 2025Review
- Myocardial composition and contractile function of right atrial trabeculae from type 2 diabetic and nondiabetic male patients.Physiological reports · 2025Article
- Elimination of hepatocyte-derived DPP4 downregulates cardiac immune- and collagen-related genes but does not alter cardiac function in aged male mice.Physiological reports · 2025Article
- Outcomes in diabetic vs nondiabetic patients requiring cardiac resynchronization therapy for heart failure: A meta-analysis.Heart rhythm O2 · 2025Article
260 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
16 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExcessive diastolic left ventricular stiffness is an important contributor to heart failure in patients with diabetes mellitus. Diabetes is presumed to increase stiffness through myocardial deposition of collagen and advanced glycation end products (AGEs). Cardiomyocyte resting tension also elevates stiffness, especially in heart failure with normal left ventricular ejection fraction (LVEF). The contribution to diastolic stiffness of fibrosis, AGEs, and cardiomyocyte resting tension was assessed in diabetic heart failure patients with normal or reduced LVEF. METHODS AND
resultsLeft ventricular endomyocardial biopsy samples were procured in 28 patients with normal LVEF and 36 patients with reduced LVEF, all without coronary artery disease. Sixteen patients with normal LVEF and 10 with reduced LVEF had diabetes mellitus. Biopsy samples were used for quantification of collagen and AGEs and for isolation of cardiomyocytes to measure resting tension. Diabetic heart failure patients had higher diastolic left ventricular stiffness irrespective of LVEF. Diabetes mellitus increased the myocardial collagen volume fraction only in patients with reduced LVEF (from 14.6+/-1.0% to 22.4+/-2.2%, P<0.001) and increased cardiomyocyte resting tension only in patients with normal LVEF (from 5.1+/-0.7 to 8.5+/-0.9 kN/m2, P=0.006). Diabetes increased myocardial AGE deposition in patients with reduced LVEF (from 8.8+/-2.5 to 24.1+/-3.8 score/mm2; P=0.005) and less so in patients with normal LVEF (from 8.2+/-2.5 to 15.7+/-2.7 score/mm2, P=NS).
conclusionsMechanisms responsible for the increased diastolic stiffness of the diabetic heart differ in heart failure with reduced and normal LVEF: Fibrosis and AGEs are more important when LVEF is reduced, whereas cardiomyocyte resting tension is more important when LVEF is normal.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.