الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
 |  | from | 4 |  |  |
| | | from | 4 | | |
Abstract
Although heart failure and diabetes were thought to co-exist as a
single entity as early as in 1881, rubler and colleagues in 1972 provided
the first evidence in four diabetic patients with overt heart failure: they
described ventricular hypertrophy and diffuse myocardial fibrosis,
independent of alcohol consumption, structural, vascular, and coronary
disease.
The term ‘diabetic cardiomyopathy’ (DCM) was coined from then
and is commonly used to describe myocardial structural and functional
changes that occur in patients with diabetes.
This prospective observational study was conducted at cardiology
departments of Al-Agoza Police Hospital, National Heart Institution,
Cairo University Hospitals and Fayoum University Hospital during the
period between October 2018 and july 2019.We enrolled the 1 st 200
consecutive patients who have type II diabetes diagnosed based on
American Diabetes Association criteria.
We exclude patients, who refused to give their written informed
consent, those with history CAD, Pacemaker or defibrillator implantation,
cerebrovascular disease and congenital heart disease. Also, patients with
other causes of cardiomyopathy.
All patients in the study underwent complete history taking,
complete general and local examination to determine if any diagnosis of
HF had been made, Twelve leads surface electrocardiogram (ECG),
Complete transthoracic echocardiography study.
DCM was diagnosed based on the presence of diabetes mellitus,
detection of myocardial abnormalities in the form of cardiac hypertrophy,
documented systolic or at least moderate diastolic dysfunction after the
diagnosis of diabetes mellitus by Echocardiography and Exclusion of
other contributory causes of cardiomyopathy.
Among the 200 patient; ischemia was excluded in 53% and 21% of
patients by C.A and CTCA respectively while 14% and 7% were
excluded by thallium and DSE, and only 5 % were excluded by CMR.
In this study, we found that only 23% of study population met the
diagnostic criteria for DCM. 29% were females 71% were males. The
mean age was 51 ± 7.02 years and the mean BMI were 28 ± 3.5.
There were 74.7% versus 19.6% has no diastolic dysfunction
among normal and DCM groups respectively while there were 25.3%
among the normal patients have diastolic dysfunction grade I. On the
other hand, there were 60.9% & 19.6% among the patients diagnosed as
having DCM were had diastolic dysfunction grade II and III respectively.
Around 78.3% of patients among DCM group were had preserved
ejection fraction versus 21.7% were had reduced ejection fraction among
the same group with mean ejection fraction was 59.78 ± 5.50 SD among
the normal group versus 54.28 ± 9.41 SD among DCM patients with
significant difference among both groups and higher in the first one (P-
value 0.04). On the other hand, we found 34.8 % of DCM patients were
had LVH but 8% of overall study patients had LVH.
We found that approaching 65% of DCM patients were had
manifest heart failure while 35% was having preclinical H.F. So early
echocardiographic diagnosis of DCM among type 2 diabetic patient in
the preclinical stage as it represent the key point for early and proper
management.