Left ventricular diastolic function (LVDF) is affected earlier than systolic function in the development of congestive cardiac failure. Therefore, left ventricular diastolic dysfunction may represent the first stage of diabetic cardiomyopathy

Echocardiography is the best noninvasive way to evaluate diastolic function and to estimate filling pressures. M-Mode, two-dimensional, and Doppler echocardiography are all helpful in evaluating diastolic function. So the present study will be undertaken to evaluate left ventricular dysfunction in type 2 Diabetes mellitus patients using echocardiographic evaluation

Transthoracic echocardiography will be performed by trained operator, using a GE VERSANA BALANCE Ultrasound System. Echocardiographer will not be aware of this study to avoid bias in the interpretation. The left ventricular systolic func­tion measurement will be based on the Teichoiz method while diastolic function will be based on the Doppler recording of left ventricular filling dynamics. The peak velocities of left ventricle filling during the early rapid (E wave m/seconds) and atrial contraction (A wave, m/second) phases, the ratio of the two filling velocities (E/A ratio), E wave deceleration time (DT in milliseconds) from the peak of the E wave to the portion at which the deceleration velocity reaches the base­line and the isovolumic relaxation time (IVRT milliseconds), the time from aortic valve closure to the beginning of the E wave will be recorded at the end of expiration for five con­secutive beats. Valsalva maneuver will be performed to unmask pseudo normal filling.  

A reduced E/A ratio of <1 and increase in the size of LA will be considered to be evidence of left ventricular diastolic dysfunction.