Sains Malaysiana 51(12)(2022):
4043-4057
http://doi.org/10.17576/jsm-2022-5112-14
Pemodelan Semula Jantung dalam Kardiomiopati Diabetes: Peranan Inflamasi, Tekanan Oksidatif dan Apoptosis yang Mendasari Pembentukan dan Perkembangannya
(Cardiac Remodeling in Diabetic Cardiomyopathy: The Role
of Inflammation, Oxidative Stress and Apoptosis Underlying Its Formation and
Development)
FATIN FARHANA JUBAIDI1, SATIRAH
ZAINALABIDIN2, IZATUS SHIMA TAIB1, ZARIYANTEY ABD HAMID1 & SITI BALKIS BUDIN1,*
1Pusat Kajian Diagnostik, Teraputik dan Penyiasatan, Fakulti Sains
Kesihatan, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Wilayah Persekutuan, Malaysia
2Pusat Kajian Toksikologi dan Risiko Kesihatan, Fakulti Sains Kesihatan, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Wilayah
Persekutuan, Malaysia
Received:16 June 2021/Accepted: 4 August 2022
Abstrak
Kardiomiopati diabetes (DCM) merupakan komplikasi kronik diabetes melitus akibat daripada perubahan pada fungsi dan struktur jantung yang diaruh oleh keadaan aras gula darah yang tinggi (hiperglisemia) secara berpanjangan. Walaupun pengawalan hiperglisemia dilakukan dengan komprehensif serta perubahan gaya hidup yang lebih sihat, komplikasi kardiovaskular termasuklah DCM terus menjadi antara punca kematian utama pesakit diabetes. Pembentukan dan perkembangan DCM adalah akibat proses kompensasi melalui pemodelan semula jantung yang melibatkan kematian kardiomiosit hasil daripada kerosakan oksidatif, apoptosis
dan inflamasi susulan aruhan hiperglisemia yang tidak terkawal. Walaupun permodelan semula jantung merupakan proses yang penting dalam memulihara struktur dan fungsi jantung, namun dalam keadaan diabetes, rangsangan pemodelan semula jantung yang berpanjangan boleh membawa kepada kemorosotan fungsi yang kekal dan akhirnya menyebabkan kegagalan jantung. Memahami mekanisme yang terlibat dalam pembentukan dan perkembangan DCM adalah sangat penting bagi merangka strategi untuk mengurangkan komplikasi akibat penyakit ini. Oleh itu, dalam kertas ulasan ini, hasil kajian terkini mengenai proses pemodelan semula jantung dalam perkembangan DCM dan mekanisme utama yang mendasari pembentukan dan perkembangannya akan diperjelaskan.
Kata kunci: Apoptosis; fibrosis; hipertrofi; inflamasi; tekanan oksidatif
Abstract
Diabetic cardiomyopathy (DCM) is one of diabetes mellitus-induced
chronic complications resulting from disturbances in cardiac structure and
function due to persistent high level of glucose in blood (hyperglycemia).
Even with comprehensive control of hyperglycemia and
changing of lifestyle towards a healthy one, cardiovascular complications
including DCM continue to become among the leading causes of death among
diabetic patients. The development and progression of DCM are the consequence
of compensative cardiac remodeling resulting from
cardiomyocyte death induced by oxidative damage, apoptosis, and inflammation
following uncontrolled hyperglycemia. Although
cardiac remodeling is a critical homeostasis process
aimed to conserve cardiac structure and function, persistent
stimulation in diabetic condition results in irreversible deterioration in
cardiac function that may end up as heart failure. Understanding the mechanisms
involved in the development and progression of DCM is of utmost importance in
order to strategize against DCM complications. Therefore, this review paper
compiled the recent discoveries regarding the cardiac remodeling process in DCM as well as unfolding the main mechanisms that underlie its
development and progression.
Keywords:
Apoptosis; fibrosis; hypertrophy; inflammation; oxidative stress
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*Corresponding author;
email: balkis@ukm.edu.my
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