Detection of Subclinical Left Ventricular Dysfunction by Two-Dimensional Speckle Tracking and Tissue Doppler Echocardiography in Young Patients with Type 1 Diabetes Mellitus

The premature development of coronary atherosclerosis is the most well-known heart disease in diabetes, however, a special subset of heart failure in diabetes has been proposed, the diabetic cardiomyopathy, which is myocardial dysfunction not caused by ischemia, valvular disease or hypertension [3]. The exact cause remains unclear. It is generally accepted that the most important mechanisms are hyperglycemia, increased free fatty acids, activation of the rennin angiotensin system, microangiopathy, increased oxidative stress, and cardiac autonomic neuropathy [4].