Tissue Doppler imaging must be performed to detect early left ventricular dysfunction in patients with type 1 diabetes mellitus

Aims We sought to compare diastolic parameters in patients having type 1 diabetes mellitus (DM) and healthy controls using both pulse-wave (PW) Doppler and relatively novel tissue-Doppler imaging (TDI) to evaluate the possible effect of diabetes on left ventricular dysfunction. Methods and results One hundred and thirty-two patients were evaluated (81 type 1 diabetic patients and 51 healthy volunteers). The detailed M-mode, two-dimensional, colour Doppler; PW Doppler; and TDI analyses were performed on resting subjects in a regular setting. Posterior wall thickness, left atrial indexed diameter, and A velocity were significantly higher in the diabetics when compared with control group (P = 0.019, 0.05 for all). However, both septal E′ and lateral E′ velocities were significantly lower in diabetics than in the control subjects on TDI echocardiographic examination (P < 0.001 and 0.011, respectively). In addition, E′/septal E′ and E/lateral E′ ratios were significantly higher in the diabetic group (P < 0.001 and 0.008, respectively). Conclusion TDI is a more accurate and powerful method than PW or M-mode in determination of early cardiac involvement related to type 1 DM even in the subclinical phase as well as hereditary cardiomyopathies.