• Hameed ullah
  • Muhammad Faheem
  • Sher Bahadar
  • Muhammad Hafizullah
  • Shahzad Najeeb


Background: Diabetes is associated with Left ventricular diastolic and systolic dysfunction known asdiabetic cardiomyopathy. Echocardiography is helpful for the detection of diastolic dysfunction andEchocardiographic screening for asymptomatic diabetic cardiomyopathy should be performed in allasymptomatic diabetic subjects. Identification of diabetic cardiomyopathy should result in the initiationof therapies to prevent the progression of diabetic cardiomyopathy. The objectives of this Descriptivecase series was to determine the effect of glycaemic status on left ventricular diastolic function innormotesive type 2 diabetic patients. Methods: This study was performed at Cardiology department,PGMI Lady Reading Hospital, Peshawar from March 2007 to September 2007. Sixty normotesive type2 diabetic patients were enrolled, 20 well control, 20 moderately control and 20 poorly control (Group-3). Main outcome measures was Left ventricular diastolic function determined by Echocardiography.Results: Out of 60 patients there were 32 (53.3%) males and 28 (46.7%) females. Mean E/A ratio inGroup 1 was 1.380.29, in Group 2 was 1.160.39 and in Group 3 was 0.600.15 (p<0.05). IVRT inGroup-1 was 917.87 mSec, in Group-2 was 1007.83 mSec and in Group-3 was 1096.45 mSec(p<0.05). DT in Group 1 was 207.2±12.6 mSec, in Group 2 was 21811.3 mSec and in Group 3 was229.7±9.52 mSec (p<0.05). Mean Em at mitral annulus in Group-1 was 0.14±0.04 m/Sec, in Group-2was 0.11±0.04 m/Sec and in Group-3 was 0.10±0.03 m/Sec (p=0.002). Left ventricular diastolicdysfunction was documented in 4 (25%) patients in Group-1, 9 (45%) patients in Group-2 and 16(80%) patients in Group-3 (p<0.05). There was Strong correlation between HbA1c level and diastolicindexes (p<0.05). Conclusion: Diastolic dysfunction is more frequent in poorly controlled diabeticpatients and its severity is correlated with glycaemic control.Keywords: Type 2 diabetes mellitus, left ventricular diastolic function, Deceleration time


Diamant M, Lamb HJ, Endert EL, Smit WA, Bax JJ, Romijn

JA, et al. Diastolic dysfunction is associated with altered

myocardial metabolism in asymptomatic normotensive

patients with well-controlled Type 2 diabetes mellitus. J Am

Coll Cardiol 2003;42:328–35.

Liu JE, Robbins DC, Palmieri V, Bella JN, Roman MJ,

Fabsitz R, et al. Association of albuminuria with systolic and

diastolic left ventricular dysfunction in Type 2 diabetes: the

Strong Heart Study. J Am Coll Cardiol 2003;41:2002–28.

Fischer M, Baessler A, Hense HW, Henstenberg, Muscholl

M, Holmen S, et al. Prevalence of left ventricular diastolic

dysfunction in the community. Eur Heart J 2003;24:320–8.

Rubler S, Dlugash J, Yuceoglu YZ, Kumral T, Branwood

AW, Grishman A, et al. New type of cardiomyopathy

associated with diabetic glomerulsclerosis. Am J Cardiol


Garcia MJ, Thomas JD, Klein AL. New Doppler

echocardiographic applications for the study of diastolic

dysfunction. J Am Coll Cardiol 1998;32:865–75.

Boyer JK, Thanigarajs, Schechtman KB, Perz JE. Prevalence

of ventricular diastolic dysfunction in asymptomatic

normotensive patients with diabetes mellitus. Am J Cardiol


Poirier P, Bogaty P, Garneau C, Marois L, Dumesnil JG.

Diastolic dysfunction in normotensive men with well

controlled Type 2 diabetes. Diabetes Care 2001;24:5–10.

ACC/AHA/ASE 2003 guidelines update for the clinical

application of echocardiography: a report of American

college of cardiology/American Heart association Task Force

on Practice Guidelines (ACC/AHA/ASE committee to update

the 1997 Guideline for the clinical application of

echocardiography). J Am Coll Cardiol 2003;42:957–70.

Wojciech K, Monika PK, Walentyna M. Comparison of left

ventricular function by tissue Doppler imaging in patients

with diabetes mellitus without systemic hypertension versus

diabetes mellitus with systemic hypertension. Am J Cardiol


Miguel Z, Magdy F, Ismail, Lori A, Fathi A. Prevalence of

diastolic dysfunction in normotensive, asymptomatic patients

with well controlled type 2 diabetes mellitus. Am J Cardiol


Liu JE, Palmieri V, Roman MJ, Bella JN, Rabsitz R, Howard

BV, et al. The impact of diabetes on left ventricular filling

pattern in normotensive and hypertensive adults: The Strong

Heart Study. J Am Cardiol 2001;37:1943–9.

Mehrdad S, Zoleikha J. Relation of HbA1c to left ventricular

diastolic function in patients with type 1 diabetes mellitus

and without overt heart disease. Diabetologia Croatica


Mehdi HS, Byron JH, Paul S, Steven PM, Jing PS, Jianbo L,

et al. Relation of hemoglobin A1c to left ventricular

relaxation in patients with type 1 diabetes mellitus and

without overt heart disease. Am J Cardiol 2003;19:1514–7.

Boyer JK, Thanigarajs, Schechtman KB, Perz JE. Prevalence

of ventricular diastolic dysfunction in asymptomatic

normotensive patients with diabetes mellitus. Am J Cardiol


Theresa CA, Rodrigo S, Rowena R, Santos, Mercelo E.

Prevalence of left ventricular diastolic dysfunction among

normotensive Filipino patients with type 2 diabetes mellitus

seen at an out patient clinic at the medical city. Phil J Internal

Medicine 2006;44:21–5.

Sohail A, Faisal B. Association of hypertension and diastolic

dysfunction with type 2 diabetes mellitus. J Pak Med Assoc


Markuszewski L, Gycewicz T, Pietruszynski R,

Michalkiewicz D, Roszczyk N. Glycosylated hemoglobin

and left ventricular diastolic dysfunction in patients with type

diabetes mellitus. Pol Merkur Lekarski 2006;21:8–11.

Young ME, McNulty P, Taegtmeyer H. Adaptation and

maladaptation of the heart in diabetes. Part II: Potential

mechanisms. Circulation 2002;105:1861–70.

Young LH. Diastolic function and type 1 diabetes. Diabetes

Care 2004;27:2081–3.



Most read articles by the same author(s)

1 2 > >>