Underlying mechanisms of cardiovascular dysfunction and complications in patients with metabolic diseases and diabetes mellitus (DM) are various and complicated. Metabolic syndrome and DM cause cardiovascular events through the progression of atherosclerosis. Insulin resistance, hypertension, and dyslipidemia are involved in the pathogenesis of atherosclerosis. In addition, a various metabolic factors including neuro-humoral factors, chronic inflammation and oxidative stress may contribute to the cardiovascular events through the dysfunction of cardiovascular metabolism. There is accumulating evidence that heart failure in patients with DM could be caused by impairment of microvascular circulation and metabolic abnormalities in cardiomyocytes. In addition to metabolic disorders in the cells or organs, inter-organ communications may play an important role in the pathogenesis of cardiac dysfunction and heart failure. However, underlying molecular mechanisms in cardiovascular dysfunction in metabolic diseases remains obscure. In this symposium, the presentations highlighting a wide range of research that will clarify the molecular basis of cardiovascular dysfunction are anticipated, and we will discuss on about possibilities of novel therapies for cardiovascular dysfunction in metabolic diseases.