Impaired Myocardial Radial Function in Asymptomatic Patients with Type 2 Diabetes Mellitus: A Speckle-Tracking Imaging Study

Background: Diabetic cardiomyopathy has been characterized by an early impairment of left ventricular (LV) longitudinal function as opposed to preserved LV radial function. Methods: Conventional echocardiography and longitudinal (epsilon(L)) and radial (epsilon(R)) systolic strain assessed by speckle-tracking imaging were obtained in 114 type 2 diabetic patients and 88 age-matched controls. Results: LV ejection fraction was similar in diabetic patients and controls. The presence of subclinical LV systolic dysfunction in diabetic patients was demonstrated by lower values of midwall fractional shortening (18% +/- 3% vs 20% +/- 3%, P = .006), epsilon(L) (-19% +/- 3% vs -22% +/- 2%, P < .001), and epsilon(R) (50% +/- 16% vs 56% +/- 12%, P = .003) compared with controls. On multivariate analysis, factors predicting strain values were diabetes (P = .001) and gender (P = .001) for epsilon(L) and diabetes (P = .003) for epsilon(R). Conclusion: Diabetic patients without overt heart disease display subclinical alteration of both radial and longitudinal LV systolic function even after adjustment for blood pressure, age, and body mass index. (J Am Soc Echocardiogr 2010;23:1266-72.)