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Abstract Aim of the work In this study, asymptomatic diabetic subjects without previously coronary artery disease were investigated to study silent myocardial ischemia and to determine whether a relation exists between silent myocardial ischemia and autonomic dysfunction. Conclusion It is concluded that autonomic nervous system dysfunction can explain the painless ischemia during daily life in asymptomatic diabetic patients. Microangiopathy can explain the occurrence of ischemia and also increased vasomotortone of coronary arteries due to decreased parasympathetic activity can explain myocardial ischemia in the absence of increased heart rate during the ischemic episodes were due to decrease myocardial blood supply, and not due increase myocardial O2 demands. We recommend follow up of diabetic patients especially those with abnormal cardiac autonomic function tests for early detection of CAD. |