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Left Ventricular Diastolic Dysfunction in Type 2 Diabetes—Progress and Perspectives

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Diabetes, Nutrition and Metabolic Diseases, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
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“Sf. Spiridon” Emergency Hospital, 700111 Iași, Romania
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Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
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Department Preventive Medicine and Interdisciplinarity, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
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Author to whom correspondence should be addressed.
Diagnostics 2019, 9(3), 121; https://doi.org/10.3390/diagnostics9030121
Received: 31 August 2019 / Revised: 11 September 2019 / Accepted: 15 September 2019 / Published: 17 September 2019
(This article belongs to the Special Issue Atherosclerosis and Vascular Imaging)
In-depth understanding of early cardiovascular manifestations in diabetes is high on international research and prevention agendas given that cardiovascular events are the leading cause of death for diabetic patients. Our aim was to review recent developments in the echocardiographic assessment of left ventricular diastolic dysfunction (LVDD) as a telltale pre-clinical disturbance preceding diabetic cardiomyopathy. We analyzed papers in which patients had been comprehensively assessed echocardiographically according to the latest LVDD guidelines (2016), and those affording comparisons with previous, widely used recommendations (2009). We found that the updated algorithm for LVDD is more effective in predicting adverse cardiovascular events in patients with established LVDD, and less specific in grading other patients (labelled “indeterminate”). This may prove instrumental for recruiting “indeterminate” LVDD cases among patients with type 2 diabetes mellitus (T2DM) in future screening programs. As an interesting consideration, the elevated values of the index E/e’ can point to early diastolic impairment, foretelling diabetic cardiomyopathy. Identifying subclinical signs early makes clinical sense, but the complex nature of T2DM calls for further research. Specifically, longitudinal studies on rigorously selected cohorts of diabetic patients are needed to better understand and predict the subtle, slow onset of cardiac manifestations with T2DM as a complicating backdrop. View Full-Text
Keywords: type 2 diabetes; echocardiography; left ventricular diastolic dysfunction; E/e’ index; diabetic cardiomyopathy type 2 diabetes; echocardiography; left ventricular diastolic dysfunction; E/e’ index; diabetic cardiomyopathy
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Grigorescu, E.-D.; Lacatusu, C.-M.; Floria, M.; Mihai, B.-M.; Cretu, I.; Sorodoc, L. Left Ventricular Diastolic Dysfunction in Type 2 Diabetes—Progress and Perspectives. Diagnostics 2019, 9, 121.

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