Cardiovascular autonomic neuropathy in diabetes

Takahide Arai, Masaki Ieda, Keiichi Fukuda

研究成果: Chapter

抜粋

The heart is extensively innervated, and its electrical and mechanical performance is controlled by the autonomic nervous system. The cardiac nervous system comprises the sympathetic, parasympathetic, and sensory nervous systems that together regulate heart function on demand. The density of cardiac innervation varies in diseased hearts, leading to unbalanced neural activation and lethal arrhythmia. Diabetic sensory neuropathy causes silent myocardial ischemia, which is characterized by loss of pain perception during myocardial ischemia and is a major cause of sudden cardiac death in diabetes mellitus (DM). Despite its clinical importance, the mechanisms underlying the control and regulation of cardiac innervation remain poorly understood. Nerve growth factor (NGF), a potent chemoattractant, is highly expressed in cardiomyocytes during development. In contrast, Sema3a, a neural chemorepellent, is highly expressed in the subendocardium of early-stage embryos, but is suppressed during development. The balance between NGF and Sema3a expression leads to epicardial to endocardial transmural sympathetic innervation patterning. Downregulation of NGF leads to diabetic neuropathy, whereas NGF supplementation rescues silent myocardial ischemia in DM. In this review, we summarize the molecular mechanisms underlying cardiac autonomic innervation, with a particular focus on DM and the clinical implications of cardiac autonomic neuropathy.

元の言語English
ホスト出版物のタイトルDiabetic Cardiomyopathy
ホスト出版物のサブタイトルBiochemical and Molecular Mechanisms
出版者Springer New York
ページ239-248
ページ数10
ISBN(電子版)9781461493174
ISBN(印刷物)9781461493167
DOI
出版物ステータスPublished - 2014 1 1

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

フィンガープリント Cardiovascular autonomic neuropathy in diabetes' の研究トピックを掘り下げます。これらはともに一意のフィンガープリントを構成します。

  • これを引用

    Arai, T., Ieda, M., & Fukuda, K. (2014). Cardiovascular autonomic neuropathy in diabetes. : Diabetic Cardiomyopathy: Biochemical and Molecular Mechanisms (pp. 239-248). Springer New York. https://doi.org/10.1007/978-1-4614-9317-4_14