Diabetic cardiomyopathy: Tissue doppler imaging a novel insight

Patients with diabetes mellitus (DM) are prone to develop heart failure even in the absence of evident hypertension and coronary artery disease. This entity is difficult to detect in early stages by conventional echocardiographic techniques. 32 asymptomatic TMT (tread mill stress test) negative DM patients compared with control subjects were screened and performed LV (left ventricle) strain, strain rate and tissue Doppler imaging. Tissue Doppler imaging revealed increased E/E' of IVS (Inter ventricular septum) (p value<0.001) among DM suggestive of diastolic dysfunction. The tissue velocities E' of both the LV lateral wall (p value=0.004) and RV (right ventricle) (p value =0.003) were reduced among DM. Similarly, the peak systolic strain (p value<0.001), and strain rate (p value<0.001) were significantly reduced among diabetic subjects. DM is an independent risk factor for myocardial dysfunction even in asymptomatic normotensive subjects. The changes that occur in the myocardium due to diabetic cardiomyopathy can be detected early, as the novel tissue Doppler is a noninvasive technique for early detection of Diabetic cardiomyopathy.