New Research Highlights How Diabetes Alters Heart Structure and Function

A groundbreaking study conducted by researchers at the University of Sydney has uncovered how type 2 diabetes significantly impacts the heart's anatomy and energy systems. Published in EMBO Molecular Medicine, the study provides vital insights into why individuals with diabetes face an increased risk of developing heart failure.

Led by Dr. Benjamin Hunter and Associate Professor Sean Lal, the team analyzed donated human heart tissue from patients undergoing heart transplantation in Sydney. Their findings reveal that diabetes induces distinct molecular alterations in heart cells and causes structural changes in the heart muscle, particularly in patients suffering from ischemic cardiomyopathy—the leading cause of heart failure.

"While links between heart disease and type 2 diabetes have long been observed, this is the first study to comprehensively examine both conditions simultaneously in humans," explained Dr. Hunter. "Our research shows that diabetes modifies how the heart generates energy, maintains its structural integrity under stress, and contracts to pump blood. We observed an accumulation of fibrous tissue in the heart muscle, which impairs its function."

The study emphasizes that diabetes affects the heart's energy production, especially by disrupting mitochondrial function—the cell's energy powerhouse—and reduces the synthesis of key structural proteins necessary for proper heart muscle contraction and calcium regulation. These molecular changes contributed to increased stress on the mitochondria and contributed to fibrotic tissue buildup, which further hampers the heart's ability to pump effectively.

Using advanced microscopy and RNA sequencing, researchers confirmed that these molecular alterations were reflected at both genetic and structural levels, reinforcing the link between diabetes and structural degeneration of heart tissue.

Associate Professor Lal highlighted the significance of these findings: "Understanding the mitochondrial dysfunction and fibrosis pathways involved offers promising avenues for developing targeted therapies. By revealing how diabetes worsens heart failure at a molecular level, we can explore new treatment strategies and improve disease management."

Heart disease remains the leading cause of mortality in Australia, with over 1.2 million Australians living with type 2 diabetes. The study’s insights could not only inform future diagnostic criteria but also inspire novel treatments aimed at reducing the burden of heart failure among diabetic populations.

Overall, this research underscores the profound impact of diabetes on cardiac health, demonstrating that the condition does not merely coexist with heart disease but actively contributes to its progression at a cellular level.

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