Context: The frequency of diabetes related heart failure is increasing along with the prevalence of diabetes. Diabetic cardiomyopathy is considered to be a distinct disease in the absence of discernable coronary artery and other defined heart disease. Previously we have shown that glucose and palmitic acid induce degeneration of myofibrils and modulate apoptosis in cultivated cardiomyocytes.

Objective: Here we studied the mechanisms of diabetic cardiomyopathy in more details.

Results: Streptozotocin-induced diabetes led to a significant increase in cardiac cell apoptosis. Furthermore, cardiomyocyte contacts were reduced. In vitro, prolonged exposure of cultured adult cardiomyocytes to high glucose concentrations drastically reduced myofibrillar formation. In particular sarcomeric myosin heavy chains and cardiac -actin were reduced whereas the non-sarcomeric smooth muscle -actin remained unaffected. The deleterious effects of glucose on myofibril formation was prevented by antioxidative regimens.

Conclusions: Thus, a diabetic milieu leads to multiple structural alterations of the heart including apoptosis, loss of intercellular contacts and malformation of contractile structures.