Left ventricular systolic and diastolic dysfunction in asymptomatic, normotensive type 2 diabetes mellitus

Abstract

Diastolic dysfunction has been described as an early sign of diabetic heart muscle disease preceding the systolic damage. The present study was taken up with an objective to evaluate systolic and diastolic dysfunction in asymptomatic normotensive type 2 diabetes mellitus patients. Left ventricular function was evaluated by m-mode, 2-D echo and colour Doppler studies was done in 50 cases and compared with 50 age- and sex- matched controls. All the investigations were within normal limits except mean Fasting blood glucose of 142 ± 9.94 and post-prandial blood sugar of 226 ± 18.61. In systolic function the mean ejection fraction (EF) was 63.12 ± 6.19 and mean fractional shortening was 35.42 ± 5.03. The EF was < 50% in 3 (6%) patients, but was asymptomatic. The mean E/A ratio was 0.95 ± 0.10 and 26 (52%) had E/A ratio of < 1 as compared to 24 (48%) > 1%. The mean isovolumetric relaxation time was 87.94 ± 20.36, and mean DT of E was 180.68 ± 34.64. Left ventricular diastolic dysfunction (LVDD) is much more common than previously reported in subjects with well controlled type 2 diabetes mellitus that are free of clinically detectable heart disease.