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 BUDIN^1,*

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

Diserahkan: 16 Jun 2021/Diterima: 4 Ogos 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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^*Pengarang untuk surat-menyurat; email: balkis@ukm.edu.my