الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 126 |  |  |
| | | from | 126 | | |
Abstract
Diabetic heart disease (DHD) is defined as myocardial dysfunction that occurs independently of coronary artery disease (CAD) and hypertension. This dysfunction may be subclinical but patients are at high risk of developing clinical heart failure.
Diastolic dysfunction (DD) which is an important predictor of heart failure is commonly encountered in type 2 diabetes mellitus (T2DM). Left ventricular diastolic dysfunction (LVDD) is the early preclinical manifestation of cardiomyopathy. The Etiopathogenesis of this DD still remains unclear. Clinical sequelae from early DD could be averted or delayed if early identification occurs via a reliable noninvasive approach such as Tissue Doppler Imaging (TDI). The study aims to assess role of TDI in evaluation of subclinical LVDD in T2DM with normal coronary angiogram. This cross-sectional observational comparative study was conducted at Cardiology Department in Specialized Medical Hospital, faculty of medicine, Mansoura University during the period from March 2017 to March 2018 after approval of the local ethical committee of Faculty of Medicine, Mansoura University. 40 Patients with type 2 diabetes Mellitus (insulin dependent or non-dependent), with variable durations of diabetes, free of coronary artery disease (normal resting 12-lead ECG/normal coronary angiogram) were included. We excluded patients with hypertension, valvular heart disease, congenital heart disease and atrial fibrillation. Results: TDI has statistically significant higher sensitivity in detection of DD than Conventional echocardiography. There was significant relation between obesity and grades of DD by TDI grade II and III more associated with BMI >30 represent (70%, 30%) respectively. (p value <0.001). There was no statistically significant relation between obesity and grades of DD by conventional echocardiography. (p value >0.05). There was significant relation between duration of DM and grades of DD by TDI (p value <0.001). There was no statistically significant relation between duration of DM and grades of DD by conventional echocardiography. (p value >0.05). There was no significant relationship between treatment strategies of DM and grades of DD by both conventional echocardiography and TDI. Presence of diabetic complication was strongly significant predictor of DD assessed by TDI in contrast to conventional echocardiography which showed no statistically significant correlation. Conclusion: Diabetes mellitus is an independent causative factor for development of diastolic dysfunction which can be latent in majority of cases. Tissue Doppler imaging unmasks the presence of subclinical LV diastolic dysfunction in asymptomatic diabetic patients with more frequency than pulsed wave Doppler.