The earliest change that occurs in the diabetic heart is reduced glucose consumption, with a switch to utilization of
fatty acids (FA) predominantly as an energy resource. Although this adaptation might be beneficial in the short-term, over
a protracted duration, it is potentially catastrophic given the malicious effects produced by high FA in cardiomyocytes. In
this review, we describe how the endothelial cell (EC), a “first-responder” to hyperglycemia, communicates with the
underlying cardiomyocyte. As this cross-talk is expected to facilitate increased FA delivery to, and utilization by, the
cardiomyocyte, understanding this conversationshould assist in devising new therapeutic strategies to prevent or delay
diabetic heart disease.
Keywords: Cardiomyopathy, fatty acids, heparanase, LPL, metabolism, VEGF.
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