Abstract：
The association between type 2 diabetes mellitus (T2DM) and heart failure (HF) has been firmly established; however, the entity of diabetic myocardial disorder (previously called diabetic cardiomyopathy) remains a matter of debate. Diabetic myocardial disorder was originally described as the occurrence of myocardial structural/functional abnormalities associated with T2DM in the absence of coronary heart disease, hypertension and/or obesity. However, supporting evidence has been derived from experimental and small clinical studies. Only a minority of T2DM patients are recognized as having this condition in the absence of contributing factors, thereby limiting its clinical utility. Therefore, this concept is increasingly being viewed along the evolving HF trajectory, where patients with T2DM and asymptomatic structural/functional cardiac abnormalities could be considered as having pre-HF. The importance of recognizing this stage has gained interest due to the potential for current treatments to halt or delay the progression to overt HF in some patients. This document is an expert consensus statement of the Heart Failure Association of the ESC and the ESC Working Group on Myocardial & Pericardial Diseases. It summarizes contemporary understanding of the association between T2DM and HF and discuses current knowledge and uncertainties about diabetic myocardial disorder that deserve future research. It also proposes a new definition, whereby diabetic myocardial disorder is defined as systolic and/or diastolic myocardial dysfunction in the presence of diabetes. Diabetes is rarely exclusively responsible for myocardial dysfunction, but usually acts in association with obesity, arterial hypertension, chronic kidney disease and/or coronary artery disease, causing additive myocardial impairment.
摘要：
2型糖尿病（T2DM）和心力衰竭（HF）之间的关联已被确定；然而，糖尿病性心肌病（以前称为糖尿病性心肌病）的实体仍存在争议。糖尿病性心肌病最初被描述为在没有冠心病的情况下发生与T2DM相关的心肌结构/功能异常。高血压和/或肥胖。然而,支持证据来自实验和小型临床研究。只有少数2型糖尿病患者在缺乏因素的情况下被认为患有这种疾病。从而限制了其临床应用。因此,这个概念越来越多地沿着不断发展的HF轨迹进行观察，其中T2DM和无症状的结构/功能心脏异常患者可被认为患有HF前期。认识到这一阶段的重要性已经引起了人们的兴趣,这是由于当前治疗在一些患者中可能停止或延迟向明显HF的进展。本文件是ESC心力衰竭协会和ESC心肌和心包疾病工作组的专家共识声明。它总结了对T2DM和HF之间关联的当代理解，并讨论了有关糖尿病性心肌病的当前知识和不确定性，值得未来研究。它还提出了一个新的定义，其中糖尿病性心肌紊乱被定义为在存在糖尿病的情况下的收缩和/或舒张性心肌功能障碍。糖尿病很少是心肌功能障碍的唯一原因，但通常与肥胖有关，动脉高血压,慢性肾脏疾病和/或冠状动脉疾病，导致附加的心肌损伤。
