REN and Insulin resistance: Hyperglycemia, insulin resistance, and hyperinsulinemia could trigger a cascade of deleterious effects, such as inflammation, dyslipidemia, endothelial dysfunction, activation of the renin–angiotensin–aldosterone system, autonomic dysfunction, and cardiac fibrosis, which further cause both ischemic cardiomyopathy and diabetic cardiomyopathy, predisposing HF development [5].