Tissue Doppler image during dobuatmine stress for detection of sub-clinical myocardial dysfunction in diabetic patients

The prevalence of type 2 diabetes mellitus is rapidly increasing. Myocardial dysfunction may be a consequence of diabetic cardiomyopathy and it contributes to the poor prognosis of diabetic patients. Evaluation of subclinical myocardial dysfunction in diabetic patients. Thirty patients with type 2 diabetes and thirty control subjects without clinical signs of coronary artery disease and with normal left ventricular function by standard 2D echocardiography, were investigated with DTI at rest and and at peak stress echocardiography (DSE). Myocardial function was calculated as mean value from four basal left ventricular segments for the peak velocity at systole (Sm), early diastole (Em), atrial contraction (Am) and ratio E/A. At rest diabetic patients had significant compromised Em (P < 0.01), higher Am) P < 0.02), lower E/A (P < 0.001) and insignificant Em than in the control group. At stress patients with diabetes showed increased Em by 17.6%, Am by 11.8%, E/A by 6.6% and Sm by 14.6% compared to baseline values. In the control group changes in myocardial function induced by stress were more pronounced: Em increased by 34.3%, Am 15.8% , E/A by 15.4% and Sm by 37.8%. Impaired response of myocardial function during (DSE) in diabetic patients resulted to more significant difference in Em (P < 0.001) and significant difference in Sm (P < 0.001) between diabetic patients and controls after stress. Patients with type 2 diabetes have early signs of diastolic and systolic myocardial dysfunction which are more expressed at DSE. Which can be identified by DTI before appearance of signs of cardiovascular disease.