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350 Cardio Diabetes Medicine 2017

“Echocardiographic Evaluvation

of A Diabetic Patient”

Prof. Dr. V. Amuthan
MD DM FACC FASE FESC FCSI FIAE
Emeritus Professor of Cardiology, The Tamil Nadu Dr. MGR Medical University
Professor & HOD of Cardiology (Retired) Madurai Medical College, Madurai
Director of 3D Echocardiography, Jeyalakshmi Heart Centre, Madurai
Senior Interventional Cardiologist, Vadamalayan Hospital, Madurai
Dr. R. V.a. Ananth

MBBS, PGDCC,
Consultant Cardiologist, Jeyalakshmi Heart Centre, Madurai

Cardiac problems develop in concert with develop- (Fig1) Evaluation of a Diabetic patient by Echocardi-
ment of Diabetes . The 2011 estimate of 360 million ography in relation to severity
1
people with Diabetes globally is estimated to increase
to 552 million by 2030 . This epidemic proportion of
2
Diabetes in the context of the fact that India is the Di-
abetic capital of the world has necessitated the early
diagnosis of Cardiac problems in Diabetes. Although
the conventional two-dimensional echocardiography
and doppler studies remain the sheet anchor of di-
agnosis, early diagnosis is missed by these technol-
ogies. Three-dimensional echocardiography and the
use of speckle tracking echocardiographic analysis
of Longitudinal, Circumferential, radial strain and LV
torsional deformation analysis score over the earlier
techniques .
3.4

Advantages/
Early Middle Late
Disadvantages
Diastolic dysfunction Systolic dysfunc- Universally available
1.↑ E/A tion
Conventional 2D 2.↑LV Mass ↓ LV Ejection Interobserver Vari-
Echo & Dopplert ability
3.↓ Cavity size Fraction
4.↑ Deceleration Time
Quantification of
Tissue Doppler Im- E/e’ > 14 Abnormal strain myocardial velocities
aging
Angle dependent
Systolic Strain Technique is available
Abnormal Longitudi-
3D Echo and Strain nal & Circumferential Diastolic Strain abnor- Abnormalities in only high-end ma-
by Speckle tracking malities GLS < -14 chines and requires
strain
expertise
Technique is available
3D Echo and Myocar- Higher peak and time Attenuated and delayed
dial mechanics by LV to peak twist and LV twist and untwist in only high-end ma-
chines and requires
Torsion Untwist angle angle
expertise

GCDC 2017