Alteration of Myocardial Deformations in Diabetes: Relationship to Micro-angiopathy
Alteration of Myocardial Deformations in Diabetes: Relationship to Micro-angiopathy
Despite careful monitoring of patients with diabetes, it is so far difficult to predict the
 occurrence of cardiac events in the evolution. As shown by various studies conducted in
 patients with diabetes, cardiac involvement can be detected by abnormalities of diastolic or
 systolic functions using non-invasive investigations such as echocardiography. For 4 years,
 the evaluation technique of myocardial deformations by two-dimensional speckle tracking
 strain by echocardiography is the subject of high hopes in the earlier detection of still
 asymptomatic cardiomyopathies. In the present study, the investigators hypothesized that this
 technique would improve the detection of myocardial contraction abnormalities in patients
 with insulin-dependent diabetes mellitus (IDDM), and would establish their association with
 micro-angiopathy, frequently encountered in these patients.
This is a single center case-control study based on routine care, designed to recruit
 patients with type 1 diabetes mellitus free from any other myocardiopathy. The inclusion will
 take place over a period of 24 months. No monitoring of patients (no follow-up) is provided
 under this protocol. The analysis will focus on the combination of the left ventricle
 myocardial deformations alteration revealed by the echocardiographic 2D strain analysis (<
 18% in absolute value), with the existence of micro-angiopathy in type 1 diabetes mellitus
 patients with preserved left ventricular ejection fraction ( ≥ 60%).

 Two hundred subjects with type 1 diabetes mellitus will be recruited: 100 subjects with
 impaired left ventricular myocardial deformation by 2D strain analysis (< 18% in absolute
 value), constituting the 'cases' group and 100 subjects without alteration in myocardial
 deformation (global strain ≥ 18%).
Inclusion Criteria:

 -  aged between 18 and 45 years

 -  with diagnosed Type 1 diabetes mellitus (with or without complications or peripheric
 vascular micro-angiopathy)

 -  having a negative myocardial ischemic test (exercise echocardiography) in the previous
 month inclusion

 Exclusion Criteria:

 -  Known or suspected coronary artery disease

 -  atrial fibrillation

 -  hypertension

 -  moderate to severe valvular disease

 -  sequelae of myocardial infarction

 -  secondary or primary cardiomyopathy

 -  myocardial conduction abnormalities

 -  pregnancy or breastfeeding.