# Usefulness of Two-Dimensional Speckle-Tracking Echocardiography in Detecting Subclinical Left Ventricular Systolic Dysfunction in Diabetes Mellitus

## TL;DR

This study shows that two-dimensional speckle-tracking echocardiography can detect early heart dysfunction in people with diabetes who have no symptoms.

## Contribution

The study demonstrates that global longitudinal strain is a useful early marker of subclinical left ventricular dysfunction in asymptomatic diabetic patients.

## Key findings

- Diabetic patients had significantly lower global longitudinal strain compared to healthy individuals, indicating subclinical heart dysfunction.
- Global longitudinal strain correlated negatively with diabetes duration, glycated hemoglobin, and LDL cholesterol in diabetic patients.
- Age was associated with declining global longitudinal strain in the normal population, suggesting age-related cardiac changes.

## Abstract

This study aimed to evaluate left ventricular (LV) systolic function in asymptomatic patients with diabetes compared to a normal population using global longitudinal strain (GLS) measured by two-dimensional speckle-tracking echocardiography (2DSTE). Impaired LV systolic function was defined as GLS <-18%. Data were analyzed from two groups: a normal cohort (n=57) and a diabetic cohort (n=50).

In the normal group, the mean GLS was -20.1%, with 16% of individuals exhibiting impaired LV systolic function. In contrast, the diabetic group demonstrated a significantly lower mean GLS of -17.3%, with 37% showing impaired function, suggesting subclinical myocardial dysfunction in asymptomatic patients with diabetes. Correlation analysis within the diabetic group revealed a moderate negative correlation between GLS and duration of diabetes (r=-0.42, p<0.05), glycated hemoglobin levels (r=-0.35, p<0.05), and low-density lipoprotein cholesterol levels (r=-0.28, p<0.05), indicating that prolonged disease duration and poorer glycemic control are associated with reduced LV systolic function.

Further analysis of the normal group revealed no significant gender differences in GLS (p=0.12 ), but age stratification showed a trend toward declining GLS with advancing age (p=0.04 ). These findings underscore the utility of GLS as an early marker of LV dysfunction in asymptomatic patients with diabetes and highlight the influence of age on cardiac function in healthy individuals. Future studies should focus on larger cohorts to validate these results and explore therapeutic interventions to mitigate subclinical cardiac dysfunction in diabetic populations.