Why some people with diabetes develop heart failure

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In a new study from the University of Bristol, researchers found drugs that repair damage to a gel-like layer in the tiny blood vessels of the heart could present a much-needed treatment for heart failure in people with diabetes.

The gel-like layer—called the glycocalyx—lines the inside of blood vessels and acts as a sieve to regulate how nutrients move from the blood to the heart and other tissues in the body.

The team discovered that the glycocalyx in the small blood vessels of the heart became damaged.

They found that this damage was associated with increased fluid movement into the walls of the heart, leading to swelling and increased stiffness of the heart muscle.

This prevented the heart from properly relaxing between beats, meaning the heart could not pump blood around the body effectively.

In the study, the team examined if repairing the glycocalyx improved the function of the heart.

Diabetic mice were given a substance known to restore the glycocalyx, called angiopoietin 1. At three hours after treatment, the researchers found that glycocalyx coverage and thickness had increased in the blood vessels.

When they looked at the ultrasound scans of the heart, their ability to relax between beats also improved.

Scientists are now one step closer to better understanding why some people with diabetes develop heart failure, for which there is no cure.

Often these people don’t have problems such as high blood pressure or coronary artery disease, which often lead to heart failure. Instead, they have problems with the small blood vessels supplying the heart muscle.

The team plans to identify key changes in the glycocalyx of diabetic patients. Further research is needed to determine whether protecting the glycocalyx from breaking down can lessen heart problems seen in these people.

These findings have far-reaching implications in protecting against other types of organ failure since the glycocalyx is present in all blood vessels.

If you care about diabetes, please read studies about common vegetables that may reduce kidney damage caused by diabetes, and why more than half of people with type 2 diabetes die from heart disease.

For more information about heart health, please see recent studies about a new early warning sign for heart disease, and results showing common high blood pressure drugs may increase risk of this heart disease.

The study is published in Diabetologia and was conducted by Professor Simon Satchell et al.

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