Microcirculatory disturbances in diabetic heart and the consequences: Abnormal coronary microcirculation is an integral part of the pathophysiology of both ischemic and non-ischemic cardiomyopathies, and is not only a unique tool to aid diagnosis and determination of prognosis, but also to guide interventions and management.Microcirculatory dysfunction is well documented, even in the pre-diabetic state;it involves alterations in coronary circulation, globally as well as regionally, even in absence of large coronary obstructive lesions.My background to Diabetic coronary microcirculation research: We and other research groups found that disturbances in the levels of microcirculatory growth factor are central key in the development and progression of diabetic cardiomyopathy.Most recently our research group has focused on findings ways of correcting altered microcirculation in diabetic heart.Vascular endothelial growth factor (VEGF), a major vascular factor involved in all three types of vascular growth (angiogenesis, arteriogenesis and atherogenesis), acts as a central trigger leading to all the structural and functional changes in diabetic myocardiam, such as decreased and abnormal coronary collateral development, abnormalities in coronary flow reserve, coronary microvascular rarefaction, myocardial hypertrophy, myocyte death, and varying degrees of fibrosis, impaired myocardial function, defective cardiac progenitor cell growth and myocyte formation.Thus, a diagnostic tool based on coronary microcirculation in diabetic subjects and the therapeutic approach for the restoration of VEGF, as well as coronary microcirculation, is crucial for the prevention and treatment of diabetic cardiac complication.Our findings at this regard: We previously have used pharmacological intervention in diabetic model and systematically assessed the effects of drug on the development and progression of various complications in diabetes including diabetic cardiomyopathy.We found that endothelin blockade is effective, systematically, to prevent the development and progression of various diabetic complications including those localized in the heart through the modification of respective microcirculation and the associated signal transduction.Systemic administration of endothelin blocker prevents diabetic cardiomyopathy through restoration of VEGF, prevents diabetes-mediated erectile dysfunction through VEGF upregulation, prevents the development of diabetic retinopathy and nephropathy through VEGF inhibition.Our ongoing study uses statin and has beneficial effect on heart.