© Springer Nature Singapore Pte Ltd. 2017 207
J. Xiao (ed.), Exercise for Cardiovascular Disease Prevention and Treatment,
Advances in Experimental Medicine and Biology 999,
DOI 10.1007/978-981-10-4307-9_12
Chapter 12
Exercise Amaliorates Metabolic
Disturbances and Oxidative Stress
in Diabetic Cardiomyopathy: Possible
Underlying Mechanisms
Ayman M. Mahmoud
Abstract Cardiomyopathy is a serious complication of diabetes mellitus and
occurs independently of coronary artery disease or hypertension. It manifests as
systolic/diastolic dysfunction and hypertrophy of the left ventricle and can lead to
heart failure. Hyperglycemia can trigger a series of maladaptive stimuli and result in
cardiac hypertrophy, fibrosis and reduced performance and contractility. The patho-
genesis of diabetic cardiomyopathy is a multifactorial process that includes meta-
bolic derangements such as increased oxidative stress, and altered non-oxidative
glucose pathways and lipid metabolism. Exercise is a useful non-pharmacological
strategy effective in the reduction of diabetes and obesity risk factors, and improve-
ment of antioxidant defenses, mitochondrial function and physiological cardiac
growth. It can amend multiple metabolic derangements and alterations in the dia-
betic heart. Therefore, figuring out the underlying mechanisms of exercise-induced
beneficial effects could help to develop new treatment strategies for diabetic
cardiomyopathy.
Keywords Oxidative stress • Cardiomyopathy • AGEs • Lipids
1 Introduction
Diabetes mellitus (DM) is one of the well-known risk factors for cardiovascular
disease (CVD) and heart failure [ 1 ], and CVD has been reported to be the leading
cause of morbidity and mortality in diabetic patients [ 2 ]. Forty-five years ago,
A.M. Mahmoud (*)
Physiology Division, Faculty of Science, Zoology Department, Beni-Suef University,
Beni-Suef, Egypt
e-mail: [email protected]