Cardiomyopathy in Metabolic Diseases: Pharmacological Strategies Publisher



Monemi M ; Babaeizad A ; Soleimany Darany ZS ; Naderian R ; Alibabaei F ; Hemati M ; Mahmoudian F ; Eslami M
Source: Published:2025

Abstract

Metabolic cardiomyopathy (MC) represents a significant clinical challenge, arising from metabolic disturbances such as diabetes, obesity, and dyslipidemia. These conditions contribute to myocardial lipid accumulation, oxidative stress, and chronic inflammation, leading to structural and functional cardiac impairments, including diastolic dysfunction, fibrosis, and eventual heart failure. Current treatment methods use a variety of pharmacological techniques to address the interaction between inflammation and metabolic dysregulation. These include statins, glucagon-like peptide-1 receptor agonists (GLP-1RAs), insulin-sensitizing drugs like metformin, and sodium-glucose cotransporter 2 (SGLT2) inhibitors, which treat glucose and lipid imbalances while having cardioprotective properties. Aldose reductase inhibitors and antifibrotic drugs are examples of new therapies that aim to reduce oxidative stress and fibrosis. By personalizing therapies to each patient's unique metabolic profile, personalized medicine which makes use of multiomics technologies offers a promising paradigm. The diversity of MC, in spite of advancements, emphasizes the necessity of integrative methods that combine novel treatment techniques with molecular diagnostics. This review consolidates current knowledge and highlights innovative pathways to improve outcomes in MC management. © 2025 Elsevier B.V., All rights reserved.