Objectives: This study was done to assess early left ventricular affection in asymptomatic type 1diabetes by echocardiographic strain and strain rate technique.
Background: Echocardiography is an excellent non-invasive and practical imaging tool for defining cardiac structure and function and allows ‘real-time’ visualization of the cardiac cycle. Two dimensional speckle tracking imaging allows non-invasive assessment of myocardial strain and has been shown to identify global and regional abnormalities in myocardial properties and has the advantage that it allows the measurement of all principal LV strains in an angle independent manner.
Methods: 50 subjects with type 1 DM(aged 11.64 + 2.81years ) and 20 healthy age-matched persons served as control subjects. In each patient an echocardiographic study with strain and strain rate imaging was performed.Analysis of LV deformation data included assessment of systolic strain, systolic and diastolic strain rate obtained from the apical,mid and basal segments of LV (apical two, apical three and apical four view ).
Results: The result of the present study have demonstrated the presence of subclinical left ventricular systolic and diastolic dysfunction in patients with type 1diabetes mellitus, with no diabetic related complication. Significant subclinical LV dysfunction was present in 30 % diabetic patients about 15 patients of TIDM [9 female and 6 male] (P<0.001)
Conclusion: Despite a normal LV EF and normal LV diastolic measures with 2 D Echocardiography, the diabetic patients showed impairment of LV longitudinal strain and strainrate. The presence of diabetes was an independent predictor of impairment of LV longitudinal strain and strain rate and that give more sensitivity to strain and strain rate over conventional Doppler in earlier detection of systolic function.
