Emerging role of epigenetics and miRNA in diabetic cardiomyopathy

The prevalence of heart failure independent of coronary artery disease and hypertension is increasing rapidly in diabetic patients. Thus, this pathophysiology has been recognized as a distinct clinical entity termed “diabetic cardiomyopathy.” Several studies support the notion that diabetes is a threatening insult for the myocardium resulting in functional, cellular, and structural changes manifesting as a cardiac myopathy. Recent data suggested that epigenetics including DNA and histone modifications as well as microRNAs play an important role in the development of cardiac diseases. The role of epigenetics in diabetes is largely recognized; however, its role in diabetes-associated cardiomyopathy remains elusive. Thus, molecular, cellular, and functional modulations in the diabetic cardiomyopathy will be investigated in this review. Moreover, particular attention will be drawn on the epigenetic mechanisms that may play an important role in the pathophysiology of diabetic cardiomyopathy.