Contemporary Echocardiographic Techniques in Early Detection of Diabetic Cardiomyopathy

Diabetic cardiomyopathy is defined as heart failure independent of hypertension, coronary artery and valve disease.It has multifactorial etiology and the pathogenesis is still incompletely understood.Structural changes lead to functional alterations of the left ventricle (LV) and diastolic dysfunction is the earliest sign.It has long asymptomatic period, but with the time leads to reduced contractile function.Diagnosis of diabetic cardiomyopathy is a challenge for cardiologists.As an entity, it exists for more than 4 decades, but no single diagnostic method yet and no established standard diagnostic criteria.Current technology and methods are still subjects of modification and they are not routinely used in daily practice.Therefore, late diagnosis of cardiovascular complications of diabetes is very often, even at the stage of overt heart failure.Echocardiography is a diagnostic method of choice, from practical and economic point of view, but conventional techniques-two-dimensional (2D), M-mode echocardiography and Pulsed-waved (PW) Doppler analysis have limitations and provide inconclusive results.Contemporary techniques-Tissue Doppler Imagine, Color M-mode, 2D Speckle Tracking, strain and strain-rate are more sensitive and relatively independent to the loading conditions methods that provides comprehensive assessment of myocardial tissue velocities.They have capability for early detection of LV diastolic dysfunction and identification of high risk patients for developing heart failure.The implementation of these techniques in everyday practice, as an integral part of echocardiographic evaluation of asymptomatic diabetic patients, would be of great importance of early treatment initiation, resulting in delay of disease progression.