Diabetic cardiomyopathy: classification, instrumental diagnostic methods

This review presents the international classification, analyzes in detail modern instrumental methods for the diagnosis of diabetic cardiomyopathy. In particular, the analysis was carried out of the features and diagnostic criteria of echocardiography, conventional Doppler echocardiography, tissue Doppler imaging, intravenous echocardiography using second-generation contrast agents, Dоppler acoustic echocardiography, three-dimensional echocardiography, speckle tracking echocardiography, magnetic resonance imaging, cardiovascular magnetic resonance imaging, gradient echo magnetic resonance imaging, phase contrast magnetic resonance imaging, tagged magnetic resonance imaging, multi-slice computed tomography, radionuclide myocardial perfusion imaging using ECG-gated single-photon emission computed tomography and positron emission tomography. Diabetic cardiomyopathy occurs quite often and for a long time is asymptomatic, which requires dynamic monitoring and targeted examination for early diagnosis. There are a number of informative instrumental methods of examination, which significantly expand the diagnostic possibilities and in a particular situation provide an opportunity to get an adequate picture of the cardiovascular system. Pathogenetically, diabetic cardiomyopathy is a metabolic myocardial dystrophy associated with impaired cell energy supply, protein synthesis, electrolyte exchange, micronutrient metabolism, redox processes, oxygen transport function of the blood. A significant role in its formation belongs to microangiopathies and hormonal disorders. Patients predominantly have dystrophic changes in the myocardium, which are joined by microvascular lesions with the development of clinical manifestations of non-coronary (non-atherosclerotic) ischemic heart disease, the onset of myocardial infarction not associated with coronary heart disease of atherosclerotic origin.