title: Early changes in longitudinal deformation indices in young asymptomatic patients with type 1 diabetes mellitus: assessment by speckle-tracking echocardiography.
abstract: BACKGROUND
  We explored early changes in regional left ventricular systolic and diastolic function assessed by speckle-tracking echocardiography (STE) in young asymptomatic patients with type 1 diabetes mellitus (DM), compared with healthy controls.
  
  
  METHODS
  We enrolled 30 normotensive asymptomatic patients with type 1 DM, age ≤40 years, DM duration >5 years, and left ventricular ejection fraction ≥50%; and thirty matched controls. They underwent conventional echocardiography, and tissue Doppler imaging (TDI). Myocardial deformation indices were measured by STE. We measured global longitudinal systolic strain, global longitudinal systolic strain rate, and global longitudinal early diastolic strain rate, as an average of 18 myocardial segments.
  
  
  RESULTS
  The mean age was 27.7±4.5 years, (41.7% males). The mean duration of diabetes was 14.3±5.8 years. The 2-D ejection fraction was lower in diabetic patients versus controls (P=0.03). The trans-mitral A peak was higher, and isovolumetric relaxation time longer in diabetics (P<0.05 for both). Both lateral and septal É values were lower, and E/É ratio higher in diabetics (P<0.05 for all). The global longitudinal systolic strain and strain rate were decreased in diabetics (-17.7±2.5% versus -21.2±1.7%, and -1.1±0.2 versus -1.3±0.2 s-1, P<0.001 and P=0.003, respectively). The global longitudinal early diastolic strain rate was comparable to controls (1.5±0.4 versus 1.6±0.3 s-1, respectively, P=0.33).
  
  
  CONCLUSIONS
  In asymptomatic patients with type 1 DM, global longitudinal systolic function measured by STE was impaired versus controls; diastolic function was impaired by conventional echocardiography and TDI.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt - wnammas@med.asu.edu.eg.
authors.forename: Zainab
authors.initials: Z
authors.lastname: Abdel-Salam
authors.forename: Maha
authors.initials: M
authors.lastname: Khalifa
authors.forename: Amal
authors.initials: A
authors.lastname: Ayoub
authors.forename: Amira
authors.initials: A
authors.lastname: Hamdy
authors.forename: Wail
authors.initials: W
authors.lastname: Nammas
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D058065:Diabetic Cardiomyopathies / Q000175:diagnosis* / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods*; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology; D055815:Young Adult