A Study of Left Ventricular Diastolic Dysfunction as an Early Predictor of Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus.

Background: Diabetes Mellitus (DM) is a disease with multi-system complications. Left ventricular diastolic dysfunction (LVDD) is an early stage of diabetic cardiomyopathy that can develop to heart failure. It has no clinical symptoms and can be easily diagnosed with echocardiography. Objectives:The study aims to evaluate the LVDD in Type-2 DM with no symptoms of cardiovascular disease and its association with glycaemic control(HbA1c), DM duration, and microangiopathy. Methods: The cross-sectional hospital-based study included 100 asymptomatic patients with type2 DM without evidence of cardiovascular involvement were studied. LVDD was evaluated by doppler echocardiography, which included E/A ratio, assessed in relation with age, sex, duration of diabetes and HbA1c level. Results:LVDD was present in 57 %of the type 2 DM patientswith males accounting for the majority of cases (63.2%). Diastolic dysfunction was more common in patients on oral hypoglycaemic agents (78%), insulin (2%) and/or both (19%).There was a linear progression of diastolic dysfunction with the increase age group (P = 0.001).LVDD was significantly associated with uncontrolled diabetes as measured by HbA1c levels with higher number patients among HbA1c >8.5 (71.9%; P = 0.001) and a longer duration of DM with highest among 6 -10 years (38.6%; P = 0.001) Conclusion:Overall, the prevalence of diastolic dysfunction was 57% in asymptomatic type 2 DM subjects. Our study indicates that myocardial damage in patients with diabetes affect diastole function before systolic function in asymptomatic diabetes patients.Doppler Echocardiography identifies large percentage of diabetes subjects before abnormalities are detected with clinical examination and ECG. [ABSTRACT FROM AUTHOR]