Echocardiographic evaluation of cardiac function in asymptomatic type 2 diabetes mellitus

Diabetic patients are at increased risk of cardiovascular disease. We do not have a definite data regarding the echocardiographic findings in asymptomatic type 2 diabetics in our population. The present study conducted an echocardiographic evaluation of asymptomatic type 2 diabetic patients of Kottayam district in central part of Kerala state. Hundred totally asymptomatic known type 2 diabetic patients were included in the study. Trans-thoracic echocardiography was performed in these patients and parameters were compared with age and sex matched controls. Diabetic patients were divided into three groups depending on the age, and duration of diabetes mellitus and each group was compared for E/A ratio(early diastolic flow velocity / late diastolic flow velocity), EDT(deceleration time), IVRT(Isovolumic relaxation time), EF(ejection fraction),LVmass(Left ventricular mass).The same parameters were also compared depending on the modes of therapy. Mean EDT (Early deceleration time), IVRT(Isovolumic relaxation time) , LV Mass (Left ventricular mass) ,IV septal thickness and left atrial diameter were significantly increased in the diabetic as compared with the control group. The mean E/A ratio was significantly lower in diabetic than control. There was no significant difference in ejection fraction ,LVIDD (left ventricular internal diastolic diameter), LVIDS( left ventricular internal systolic diameter) between diabetics and controls. There was a progressive increase in EDT and IVRT as the age and duration of diabetes increased. No significant difference was noted with mode of control of diabetes. Left ventricular diastolic dysfunction is much more common than previously reported in subjects with well controlled asymptomatic type 2 diabetes and clinically undetectable heart disease.