الفهرس 
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Abstract
As the most prevalent endocrinological condition worldwide, DM raises the risk of HF, cardiovascular illness, and mortality.
Even in the absence of CAD and hypertension, DM is thought to play a significant role in the development of HF. Diabetic cardiomyopathy is the name given to this ailment. Diastolic dysfunction is the current definition of diabetic cardiomyopathy. Diastolic dysfunction of the LV has been found to be the first functional modification in the course of diabetic cardiomyopathy in multiple studies of DM patients.
Conversely, in diabetic patients with maintained left ventricular ejection fraction (LVEF) and no overt CAD or heart failure, LV systolic dysfunction has been found.
The fraction of LV end-diastolic volume ejected during systole, or LVEF, has historically been used to express the LV systolic function. It has been widely utilized in clinical studies and in guideline recommendations for a variety of disorders. It is the most often used way to assess LV systolic function. Several imaging methods that are predicated on comparable measuring concepts can evaluate LVEF.
Even in cases where traditional echocardiography reveals preserved heart function, TDI has been shown in multiple studies to be a sensitive method for assessing early diastolic and longitudinal systolic cardiac dysfunction in diabetic individuals. Since the TDI was first introduced, a number of studies have shown that TDI can be used to identify subclinical systolic longitudinal dysfunction in DM patients. However, a number of technical issues, including angle dependency, have restricted the technique’s ability to acquire TDI data and reproduce it.
Despite maintained LVEF, early diagnosis of LV systolic dysfunction is possible with recent echocardiographic techniques as 2D-STE which permits GLS analysis.
A recent development in strain imaging is the speckle tracking approach, which has the benefit of measuring myocardial strain regardless of incidence angle. For this reason, speckle tracking echocardiography, or STE, holds promise as a screening method for diabetic patients who may develop cardiac dysfunction.
2D-STE is a promising new imaging modality, there is growing evidence that this modality provides cumulative information in the clinical setting.