Tissue Doppler assessment of left ventricular function in asymptomatic diabetic patients

Left ventricular diastolic dysfunction (LVDD) is very common in the diabetic population, even in the absence of coronary artery disease, valve pathology, or hypertension. It is an indicator of myocardial damage before heart failure becomes apparent and serves as a predictor of adverse cardiac events. Hence, early identification of myocardial dysfunction and correction of potentially modified risk factors are very important in order to delay the onset of heart failure. Unfortunately, subclinical cardiomyopathy is often still unrecognized in asymptomatic diabetic patients (1).