title: Asymptomatic cardiovascular manifestations in diabetes mellitus: left ventricular diastolic dysfunction and silent myocardial ischemia.
abstract: BACKGROUND
  Several cardiovascular manifestations in patients with diabetes may be asymptomatic. Left ventricular diastolic dysfunction (LVDD) is considered to be the earliest metabolic myocardial lesion in these patients, and can be diagnosed with tissue Doppler echocardiography. Silent myocardial ischemia (SMI) is a characteristic and frequently described form of ischemic heart disease in patients with diabetes. Objective The aim of the study was to assess the prevalence of LVDD and SMI in patients with type 2 diabetes, as well as to compare demographic, clinical, and metabolic data among defined groups (patients with LVDD, patients with SMI and patients with type 2 diabetes, without LVDD and SMI).
  
  
  METHODS
  We investigated 104 type 2 diabetic patients (mean age 55.4 +/- 9.1 years, 64.4% males) with normal blood pressure, prehypertension and arterial hypertension stage I. Study design included basic laboratory assessment and cardiological workup (transthoracic echocardiography and tissue Doppler, as well as the exercise stress echocardiography).
  
  
  RESULTS
  LVDD was diagnosed in twelve patients (11.5%), while SMI was revealed in six patients (5.8%). Less patients with LVDD were using metformin, in comparison to other two groups (chi2 =12.152; p=0.002). Values of HDL cholesterol (F=4.515; p=0.013) and apolipoprotein A1 (F=5.128; p= 0.008) were significantly higher in patients with LVDD.
  
  
  CONCLUSIONS
  The study confirmed asymptomatic cardiovascular complications in 17.3% patients with type 2 diabetes.
authors: Department of Endocrinology, Diabetes, and Metabolic Disorders, Clinical Centre of Serbia, Belgrade, Serbia. jpseferovic@yahoo.com
authors: Jelena P
authors: JP
authors: Seferović-Mitrović
authors: Nebojsa M
authors: NM
authors: Lalić
authors: Bosiljka
authors: B
authors: Vujisić-Tesić
authors: Katarina
authors: K
authors: Lalić
authors: Aleksandra
authors: A
authors: Jotić
authors: Arsen D
authors: AD
authors: Ristić
authors: Vojislav
authors: V
authors: Giga
authors: Milorad
authors: M
authors: Tesić
authors: Natasa
authors: N
authors: Milić
authors: Ljiljana
authors: L
authors: Lukić
authors: Tanja
authors: T
authors: Milicić
authors: Sandra
authors: S
authors: Singh
authors: Petar M
authors: PM
authors: Seferović
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000175:diagnosis*; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis*