الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Type 2 diabetes mellitus (T2DM) is a global epidemic. The global prevalence of diabetes in 2019 was estimated to be 9.3% (463 million) and is expected to increase to 10.2% (578 million) by 2030 and 10.9% (700 million) by 2045. T2DM accounts for approximately 90% of the total, with an estimated number of cases of approximately 520 million by 2030 and 630 million by 2045. Despite improvements in preventive care for patients with type 2 diabetes, cardiovascular disease remains the most common cause of death among these patients. To address this, the European guidelines recommend that echocardiography should be considered in the diagnostic work-up of patients with type 2 diabetes even in the absence of known cardiovascular disease not least because of a high prevalence of subclinical cardiac abnormalities in these patients. The cardiac changes associated with diabetes are thought to comprise thickening of the myocardium and is characterized by predominantly diastolic dysfunction, the diabetic cardiomyopathy. So, this study aimed to evaluate cardiac impairments in patients in delta region with type 2 diabetes mellitus using resting electrocardiogram and resting transthoracic echocardiography. To elucidate our results, this was a cross-sectional study carried out on 50 diabetic patients at the Department of Cardiology, Tanta University Hospitals in a period of six months starting from January 2020. All participants included in the study were subjected to the followings: Written or informed consent. Full history taking including: Age, sex, history of diabetes mellitus, hypertension, smoking, past history and family history of CAD, systemic hypertension, dyslipidemia, smoking, family history of premature coronary artery diseases, renal impairment, recent surgery or trauma. Complete clinical examination including: Vital signs: heart rate, blood pressure and respiratory rate. General examination: with attention to height, weight, body mass index (BMI), patient look, decubitus, cyanosis, jaundice, with special attention to signs of heart failure (e.g., congested neck veins and orthopnea). Local cardiac examination: abnormal pulsation, Heart sounds & murmurs. Routine laboratory tests including: Fasting blood glucose, glycated Haemoglobin, complete lipid profile: TC, TGL, LDL, HDL, VLDL. Resting twelve-leads electrocardiogram and transthoracic echocardiography. Different modalities were used: Doppler echocardiography: Continuous-wave Doppler (CW), Pulsed-wave Doppler (PW), Color-flow Doppler, Left ventricle (LV). Diastolic function: was assessed through PW Doppler echocardiography and Right ventricle (RV). Results can be summarized as follow: • A total of 50 diabetic patients included in this study, their age ranged from 41 to 63 years with mean of 51.64±5.27 years. Most of the studied patients were males (n=28, 56%) and (n=22, 44%) of them were females. • BMI, duration of diabetes and SBP were significant relations with abnormal echocardiography (P<0.05). • There was no significant relation between abnormal echocardiography with age, sex, DBP, bA1C, total cholesterol, TGL, VLDL, HDL, LDL, EF, E, A, E/A, DD, AE, LVH, BBB, ST elevation, ST depression and T wave inversion, hypertrophy, systolic anterior motion of mitral leaflet, left ventricular ejection fraction, reduced left ventricular ejection fraction, diastolic dysfunction, left atrial enlargement, reduced right ventricular function, aortic stasis, aortic regurgitation, mitral regurgitation, mitral stasis and dilated aorta ascendence of the studied patients (p>0.05). • There were significant negative correlations between abnormal echocardiography with BMI, duration of diabetes and SBP (P<0.05). • The sensitivity of EF, E, A and E/A in detecting cardiac changes in type 2 DM was 68%, 52%, 76%, 72% and specificity was 52%, 68%, 36%, 30% at cutoff value 65, 75, 65, 77.5 and AUC 0.619, 0.606, 0.538, 0.534, respectively (P> 0.05).