EVALUATION OF SUBCLINICAL LEFT VENTRICULAR MYOCARDIAL DYSFUNCTION AND SUBCLINICAL CORONARY ARTERY DISEASE IN PATIENTS WITH TYPE TWO DIABETES MELLITUS BY THREE-DIMENSIONAL SPECKLE TRACKING VERSUS CONVENTIONAL TWO-DIMENSIONAL AND SPECKLE TRACKING ECHOCARDIO

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a major global health concern related to subclinical cardiac dysfunction, particularly diabetic cardiomyopathy. Early detection of left ventricular (LV) dysfunction is crucial to prevent progression to overt heart failure.

Aim: To evaluate the diagnostic value of 3D speckle tracking echocardiography compared to conventional 2D echocardiography and 2D speckle tracking echocardiography for the early recognition of subclinical left ventricular myocardial dysfunction and Diabetic cardiomyopathy in patients with Type II diabetes mellitus.

Patients and methods:  This was Cross-sectional research in which T2DM cases and matched healthy controls have been evaluated using different types of Echocardiography modalities. Two hundred Patients and 200 healthy controls have been recruited for the study at Al-Azhar University Hospitals - Assuit, and Sohag General Hospital, Sohag.

Results: 3D-STE detected significantly lower LV strain values in T2DM patients than controls. 3D-GLS illustrated stronger reproducibility and correlation with 2D-GLS than other strain parameters. 2D-STE consistently overestimated strain values compared to 3D-STE. Diabetes status was the most significant predictor of impaired strain, while HbA1C and disease duration showed no significant correlation.

Conclusion: 3D-STE is a reliable and superior modality for detecting subclinical LV dysfunction in T2DM cases. GLS is the most consistent and reproducible strain parameter, outperforming conventional echocardiography and 2D-STE in early myocardial assessment.