Diabetic cardiomyopathy, a major complication of diabetes mellitus (DM), is preceded by a silent phase of progressive left ventricular (LV) remodeling. Our aim was to evaluate whether speckle tracking imaging (STI) was able to detect early, sub-clinical myocardial dysfunction in a population of asymptomatic type II DM patients with no signs or history of heart disease and a normal conventional echo . 114 patients with type II DM (52 ± 4 years, 45 females, HbA1c 7.7 ± 1.4%) and 88 age-matched healthy volunteers (HV) without any cardiovascular risk factor (52 ± 3 years, 58 females) underwent a conventional and STI echocardiography (Vivid 7, GE). Mean longitudinal strain (S
L
) was assessed from the basal, mid and apical segments of the myocardial walls in apical 2- and 4-chamber views. Mean radial strain (S
R
) was calculated from the short-axis view at the midventricular level. Univariate and multivariate regression analyses were used to identify the parameters contributing to the difference in S
L
and S
R
between the 2 groups. Variables used for analysis were as follows: DM, gender, BMI, systolic (sBP) and diastolic blood pressure (dBP), heart rate, IVSd and PWd thickeness, LV end-diastolic (LVEDD) and end-systolic diameters (LVESD). Clinical, conventional echo and STI parameters in the 2 groups are summurized in the table
. On univariate analysis, factors associated with a significant lower strain in type II DM patients were: DM, male gender, BMI, sBP and dBP for S
L
and DM, sex and LVESD for S
R
(p<0.05 for all). On multiple regression analysis, the only factors accociated with a significant decrease in strain in the DM group were DM (p = 0.005) and male gender (p = 0.008) for S
L
and DM (p = 0.01) for S
R
. STI is able to early detect subclinical myocardial dysfunction in a population with Type II DM. This decrease in S
L
and S
R
might be considered as a preclinical marker of diabetic cardiomyopathy.
Evaluation of left ventricular mechanical dyssynchrony in chronic heart failure patients by two-dimensional speckle tracking imaging
