{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:34:58Z","timestamp":1791923698437,"version":"4.3.4"},"reference-count":115,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T00:00:00Z","timestamp":1674691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>It has been well established that diabetes mellitus (DM) is considered as a core risk factor for the development of cardiovascular diseases. However, what is less appreciated is the fact that DM may affect cardiac function irrespective of cardiac pathologies to which it contributes, such as coronary artery disease and hypertension. Although echocardiography provides accurate and reproducible diagnostic and prognostic data in patients with DM, its use in these patients is still underappreciated, resulting in progression of DM-related heart failure in many patients. Hence, in the present review, we aimed to discuss the role of echocardiography in the contemporary management of diabetic cardiomyopathy (DCM), as well as the role of emerging echocardiographic techniques, which may contribute to earlier diagnosis and more appropriate management of this complication of DM. In order to improve outcomes, focus must be placed on early diagnosis of this condition using a combination of echocardiography and emerging biomarkers, but perhaps the more important thing is to change perspective when it comes to the clinical importance of DCM.<\/jats:p>","DOI":"10.3390\/jcdd10020046","type":"journal-article","created":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T02:30:38Z","timestamp":1674786638000},"page":"46","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Role of Echocardiography in Diabetic Cardiomyopathy: From Mechanisms to Clinical Practice"],"prefix":"10.3390","volume":"10","author":[{"given":"Hrvoje","family":"Urlic","sequence":"first","affiliation":[{"name":"Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9696-3359","authenticated-orcid":false,"given":"Marko","family":"Kumric","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josip","family":"Vrdoljak","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2060-5130","authenticated-orcid":false,"given":"Dinko","family":"Martinovic","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goran","family":"Dujic","sequence":"additional","affiliation":[{"name":"Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5433-5063","authenticated-orcid":false,"given":"Marino","family":"Vilovic","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Ticinovic Kurir","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia"},{"name":"Department of Endocrinology, Diabetes and Metabolic disorders, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1634-0635","authenticated-orcid":false,"given":"Josko","family":"Bozic","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,26]]},"reference":[{"key":"ref_1","unstructured":"National Center for Health Statistics (2018, December 23). Mortality Multiple Cause Micro-data Files, 2015: Public-Use Data File and Documentation: NHLBI Tabulations, Available online: https:\/\/www.cdc.gov\/nchs\/nvss\/mortality_public_use_data.htm."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e67","DOI":"10.1161\/CIR.0000000000000558","article-title":"American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association","volume":"137","author":"Benjamin","year":"2018","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.ahj.2007.08.002","article-title":"Influence of diabetes on characteristics and outcomes in patients hospitalized with heart failure: A report from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF)","volume":"154","author":"Greenberg","year":"2007","journal-title":"Am. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/0002-9149(72)90595-4","article-title":"New type of cardiomyopathy associated with diabetic glomerulosclerosis","volume":"30","author":"Rubler","year":"1972","journal-title":"Am. J. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Katogiannis, K., Vlastos, D., Kousathana, F., Thymis, J., Kountouri, A., Korakas, E., Plotas, P., Papadopoulos, K., Ikonomidis, I., and Lambadiari, V. (2020). Echocardiography, an Indispensable Tool for the Management of Diabetics, with or without Coronary Artery Disease, in Clinical Practice. Medicina, 56.","DOI":"10.3390\/medicina56120709"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1161\/CIRCRESAHA.117.311586","article-title":"Diabetic Cardiomyopathy: An Update of Mechanisms Contributing to This Clinical Entity","volume":"122","author":"Jia","year":"2018","journal-title":"Circ. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s11886-016-0759-0","article-title":"Update on Echocardiographic Assessment in Diabetes Mellitus","volume":"18","author":"Wang","year":"2016","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"169","DOI":"10.4250\/jcu.2011.19.4.169","article-title":"Use and Limitations of E\/e\u2019 to Assess Left Ventricular Filling Pressure by Echocardiography","volume":"19","author":"Park","year":"2011","journal-title":"J. Cardiovasc. Ultrasound"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1001\/archinternmed.2007.83","article-title":"Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH) Investigators. Effect of moderate or intensive disease management program on outcome in patients with heart failure: Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH)","volume":"168","author":"Jaarsma","year":"2008","journal-title":"Arch. Intern. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"H1426","DOI":"10.1152\/ajpheart.01016.2007","article-title":"Is reduced SERCA2a expression detrimental or beneficial to postischemic cardiac function and injury? Evidence from heterozygous SERCA2a knockout mice","volume":"294","author":"Talukder","year":"2008","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1136\/postgradmedj-2015-133281","article-title":"Pathophysiology of type 1 and type 2 diabetes mellitus: A 90-year perspective","volume":"92","author":"Zaccardi","year":"2016","journal-title":"Postgrad. Med. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/ehjci\/jex241","article-title":"Dynamic change in left ventricular apical back rotation: A marker of diastolic suction with exercise","volume":"19","author":"Hong","year":"2018","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1007\/s12350-010-9255-x","article-title":"Anatomy and physiology of coronary blood flow","volume":"17","author":"Schelbert","year":"2010","journal-title":"J. Nucl. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1210\/er.2003-0012","article-title":"Diabetic cardiomyopathy: Evidence, mechanisms, and therapeutic implications","volume":"25","author":"Fang","year":"2004","journal-title":"Endocr. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"H1058","DOI":"10.1152\/ajpheart.00047.2006","article-title":"Calcification of human vascular smooth muscle cells: Associations with osteoprotegerin expression and acceleration by high-dose insulin","volume":"292","author":"Olesen","year":"2007","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3937","DOI":"10.2337\/db15-0472","article-title":"Direct Endothelial Nitric Oxide Synthase Activation Provides Atheroprotection in Diabetes-Accelerated Atherosclerosis","volume":"64","author":"Sharma","year":"2015","journal-title":"Diabetes"},{"key":"ref_17","first-page":"9","article-title":"Coronary microvascular abnormalities in the hypertensive-diabetic rat. A primary cause of cardiomyopathy?","volume":"116","author":"Factor","year":"1984","journal-title":"Am. J. Pathol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.jacc.2013.02.092","article-title":"A novel paradigm for heart failure with preserved ejection fraction: Comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation","volume":"62","author":"Paulus","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/j.molcel.2018.01.010","article-title":"A Metabolic Basis for Endothelial-to-Mesenchymal Transition","volume":"69","author":"Xiong","year":"2018","journal-title":"Mol. Cell"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1002\/path.4653","article-title":"In Brief: Endothelial-to-mesenchymal transition","volume":"238","author":"Orlova","year":"2016","journal-title":"J. Pathol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.cjca.2019.11.036","article-title":"CCS\/CHFS Heart Failure Guidelines: Clinical Trial Update on Functional Mitral Regurgitation, SGLT2 Inhibitors, ARNI in HFpEF, and Tafamidis in Amyloidosis","volume":"36","author":"McDonald","year":"2020","journal-title":"Can. J. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"179057","DOI":"10.1155\/2011\/179057","article-title":"\u03b2-Adrenergic Receptor-Stimulated Cardiac Myocyte Apoptosis: Role of \u03b21 Integrins","volume":"2011","author":"Amin","year":"2011","journal-title":"J. Signal Transduct."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.2337\/diacare.26.5.1553","article-title":"Diabetic autonomic neuropathy","volume":"26","author":"Vinik","year":"2003","journal-title":"Diabetes Care"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"434","DOI":"10.2337\/dc09-1294","article-title":"Cardiac autonomic neuropathy in diabetes: A clinical perspective","volume":"33","year":"2010","journal-title":"Diabetes Care"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1038\/ki.2008.313","article-title":"Angiotensin receptor blockers improve insulin resistance in type 2 diabetic rats by modulating adipose tissue","volume":"74","author":"Lee","year":"2008","journal-title":"Kidney Int."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1172\/JCI29069","article-title":"Inflammation and insulin resistance","volume":"116","author":"Shoelson","year":"2006","journal-title":"J. Clin Investig."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1177\/1358863X12450094","article-title":"Link between the renin-angiotensin system and insulin resistance: Implications for cardiovascular disease","volume":"17","author":"Zhou","year":"2012","journal-title":"Vasc. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"bjgpopen17X101013","DOI":"10.3399\/bjgpopen17X101013","article-title":"Prognosis following a diagnosis of heart failure and the role of primary care: A review of the literature","volume":"1","author":"Jones","year":"2017","journal-title":"BJGP Open"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1093\/eurheartj\/ehv134","article-title":"Clinical diabetic cardiomyopathy: A two-faced disease with restrictive and dilated phenotypes","volume":"36","author":"Paulus","year":"2015","journal-title":"Eur. Heart J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1093\/cvr\/cvs353","article-title":"Deranged myofilament phosphorylation and function in experimental heart failure with preserved ejection fraction","volume":"97","author":"Hamdani","year":"2013","journal-title":"Cardiovasc. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.jacc.2005.09.050","article-title":"The pathogenesis of myocardial fibrosis in the setting of diabetic cardiomyopathy","volume":"47","author":"Asbun","year":"2006","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1161\/CIRCULATIONAHA.111.076075","article-title":"Low myocardial protein kinase G activity in heart failure with preserved ejection fraction","volume":"126","author":"Hamdani","year":"2012","journal-title":"Circulation"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1093\/ejechocard\/jen123","article-title":"Doppler myocardial imaging in the diagnosis of early systolic left ventricular dysfunction in diabetic rats","volume":"9","author":"Weytjens","year":"2008","journal-title":"Eur. J. Echocardiogr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1136\/heartjnl-2014-307040","article-title":"Pathophysiological rationale and diagnostic targets for diastolic stress testing","volume":"101","author":"Erdei","year":"2015","journal-title":"Heart"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/S0002-8703(03)00322-3","article-title":"Spectral pulsed tissue Doppler imaging in diastole: A tool to increase our insight in and assessment of diastolic relaxation of the left ventricle","volume":"146","author":"Cramer","year":"2003","journal-title":"Am. Heart J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1053\/euje.2000.0066","article-title":"Subgroup on Transesophageal Echocardiography and Valvular Heart Disease; Working Group on Echocardiography of the European Society of Cardiology. Guidelines from the Working Group. Recommendations for performing transesophageal echocardiography","volume":"2","author":"Flachskampf","year":"2001","journal-title":"Eur. J. Echocardiogr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/j.echo.2020.03.009","article-title":"Echocardiography in the Era of Obesity","volume":"33","author":"Litwin","year":"2020","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2539","DOI":"10.1093\/eurheartj\/ehm037","article-title":"How to diagnose diastolic heart failure: A consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology","volume":"28","author":"Paulus","year":"2007","journal-title":"Eur. Heart J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.echo.2004.02.007","article-title":"Triphasic mitral inflow velocity with middiastolic filling: Clinical implications and associated echocardiographic findings","volume":"17","author":"Ha","year":"2004","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/S0894-7317(97)70063-4","article-title":"Doppler evaluation of left and right ventricular diastolic function: A technical guide for obtaining optimal flow velocity recordings","volume":"10","author":"Appleton","year":"1997","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/0735-1097(88)90416-0","article-title":"Relation of transmitral flow velocity patterns to left ventricular diastolic function: New insights from a combined hemodynamic and Doppler echocardiographic study","volume":"12","author":"Appleton","year":"1988","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"275","DOI":"10.5543\/tkda.2021.69548","article-title":"Cardiovascular disintegration: A conceptual, model-based approach to heart failure hemodynamics","volume":"49","author":"Aslanger","year":"2021","journal-title":"Turk. Kardiyol. Dern. Ars."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/j.cardfail.2007.01.010","article-title":"Restrictive filling pattern is a powerful predictor of heart failure events postacute myocardial infarction and in established heart failure: A literature-based meta-analysis","volume":"13","author":"Somaratne","year":"2007","journal-title":"J. Card. Fail."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1161\/01.RES.1.2.162","article-title":"The functional anatomy of ventricular contraction","volume":"1","author":"Rushmer","year":"1953","journal-title":"Circ. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e396","DOI":"10.1161\/CIRCULATIONAHA.105.579268","article-title":"A clinician\u2019s guide to tissue Doppler imaging","volume":"113","author":"Ho","year":"2006","journal-title":"Circulation"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/S0894-7317(98)70151-8","article-title":"Real-time strain rate imaging of the left ventricle by ultrasound","volume":"11","author":"Heimdal","year":"1998","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1016\/j.amjcard.2008.02.067","article-title":"Echocardiographic assessment of left ventricular diastolic function and filling pressure in atrial fibrillation","volume":"101","author":"Finstuen","year":"2008","journal-title":"Am. J. Cardiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1093\/ehjci\/jew082","article-title":"Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"17","author":"Nagueh","year":"2016","journal-title":"Eur. Heart J. Cardiovasc. Imaging."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1093\/ejechocard\/jep007","article-title":"Recommendations for the evaluation of left ventricular diastolic function by echocardiography","volume":"10","author":"Nagueh","year":"2009","journal-title":"Eur. J. Echocardiogr."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/S0735-1097(97)00144-7","article-title":"Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician\u2019s Rosetta Stone","volume":"30","author":"Nishimura","year":"1997","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1928","DOI":"10.1161\/01.CIR.0000015076.37047.D9","article-title":"Mitral ratio of peak early to late diastolic filling velocity as a predictor of mortality in middle-aged and elderly adults: The Strong Heart Study","volume":"105","author":"Bella","year":"2002","journal-title":"Circulation"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1161\/01.RES.87.12.1123","article-title":"Myocardial cell death in human diabetes","volume":"87","author":"Frustaci","year":"2000","journal-title":"Circ. Res."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1908","DOI":"10.1111\/echo.14698","article-title":"Diastolic function assessment by echocardiography: A practical manual for clinical use and future applications","volume":"37","author":"Henein","year":"2020","journal-title":"Echocardiography"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"71","DOI":"10.7863\/jum.2011.30.1.71","article-title":"Echocardiography Study Group Of The Italian Society Of Cardiology (Rome, Italy). Speckle-tracking echocardiography: A new technique for assessing myocardial function","volume":"30","author":"Mondillo","year":"2011","journal-title":"J. Ultrasound Med."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Cameli, M., Sengupta, P., and Edvardsen, T. (2017). The EACVI Textbook of Echocardiography, Oxford University Press. [2nd ed.].","DOI":"10.1093\/med\/9780198726012.003.0004"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/j.yjmcc.2009.06.021","article-title":"Diagnostic approaches for diabetic cardiomyopathy and myocardial fibrosis","volume":"48","author":"Maya","year":"2010","journal-title":"J. Mol. Cell. Cardiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"355","DOI":"10.4142\/jvs.2013.14.3.355","article-title":"Evaluation of changes in left ventricular myocardial function observed in canine myocardial dysfunction model using a two-dimensional tissue tracking technique","volume":"14","author":"Hamabe","year":"2013","journal-title":"J. Vet. Sci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1016\/j.jcmg.2019.01.044","article-title":"2- and 3-Dimensional Myocardial Strain in Cardiac Health and Disease","volume":"12","author":"Voigt","year":"2019","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.acvd.2017.01.014","article-title":"Layer-specific deformation of the left ventricle in uncomplicated patients with type 2 diabetes and arterial hypertension","volume":"111","author":"Tadic","year":"2018","journal-title":"Arch. Cardiovasc. Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jdiacomp.2017.07.022","article-title":"The importance of subclinical left ventricular dysfunction and blood pressure pattern in asymptomatic type-2 diabetic patients: The diagnostic and prognostic significance of Tissue Doppler parameters, left ventricular global longitudinal strain, and nighttime blood pressure during sleep","volume":"32","author":"Stevanovic","year":"2018","journal-title":"J. Diabetes Complicat."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1093\/ehjci\/jev164","article-title":"Left and right ventricular systolic function impairment in type 1 diabetic young adults assessed by 2D speckle tracking echocardiography","volume":"17","author":"Wilczewska","year":"2016","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Loncarevic, B., Trifunovic, D., Soldatovic, I., and Vujisic-Tesic, B. (2016). Silent diabetic cardiomyopathy in everyday practice: A clinical and echocardiographic study. BMC Cardiovasc. Disord., 16.","DOI":"10.1186\/s12872-016-0395-z"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s10741-012-9313-3","article-title":"Diabetic cardiomyopathy: Pathophysiology and clinical features","volume":"18","author":"Miki","year":"2013","journal-title":"Heart Fail. Rev."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"e003643","DOI":"10.1161\/CIRCIMAGING.115.003643","article-title":"Impact of Improved Glycemic Control on Cardiac Function in Type 2 Diabetes Mellitus","volume":"9","author":"Leung","year":"2016","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1016\/j.jcmg.2015.07.013","article-title":"Global Longitudinal Strain Is a Superior Predictor of All-Cause Mortality in Heart Failure with Reduced Ejection Fraction","volume":"8","author":"Jensen","year":"2015","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1186\/s12933-018-0782-0","article-title":"Left ventricular subclinical myocardial dysfunction in uncomplicated type 2 diabetes mellitus is associated with impaired myocardial perfusion: A contrast-enhanced cardiovascular magnetic resonance study","volume":"17","author":"Liu","year":"2018","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1832","DOI":"10.1016\/j.jcmg.2022.05.019","article-title":"Impact of Empagliflozin on Left Ventricular Strain: Insights From the EMPA-HEART CardioLink-6 Randomized Clinical Trial","volume":"15","author":"Moses","year":"2022","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.echo.2013.11.002","article-title":"Use of three-dimensional speckle-tracking echocardiography for quantitative assessment of global left ventricular function: A comparative study to three-dimensional echocardiography","volume":"27","author":"Luis","year":"2014","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"(2016). Myocardial dysfunction identified by three-dimensional speckle tracking echocardiography in type 2 diabetes patients relates to complications of microangiopathy. J. Cardiol., 68, 282\u2013287.","DOI":"10.1016\/j.jjcc.2016.03.007"},{"key":"ref_70","first-page":"107","article-title":"Three-Dimensional Echocardiography: Current Status and Real-Life Applications","volume":"33","author":"Wu","year":"2017","journal-title":"Acta Cardiol. Sin."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1007\/s10554-020-01833-5","article-title":"Quantitative evaluation of subclinical left ventricular dysfunction in patients with type 2 diabetes mellitus by three-dimensional echocardiography","volume":"36","author":"Chen","year":"2020","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Huang, J., Hu, H.L., Yan, Z.N., Fan, L., Rui, Y.F., Shen, D., and Li, J. (2019). Peak systolic longitudinal rotation: A new tool for detecting left ventricular systolic function in patients with type 2 diabetes mellitus by two-dimensional speckle tracking echocardiography. BMC Cardiovasc. Disord., 19.","DOI":"10.1186\/s12872-019-1119-y"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.1253\/circj.CJ-16-0488","article-title":"Impaired Mechanics of Left Ventriculo-Atrial Coupling in Patients with Diabetic Nephropathy","volume":"80","author":"Mochizuki","year":"2016","journal-title":"Circ. J."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1177\/1479164116655558","article-title":"Evaluation of the role of left atrial strain using two-dimensional speckle tracking echocardiography in patients with diabetes mellitus and heart failure with preserved left ventricular ejection fraction","volume":"13","author":"Zafirovska","year":"2016","journal-title":"Diabetes Vasc. Dis. Res."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s10554-018-1461-7","article-title":"Left atrial, ventricular and atrio-ventricular strain in patients with subclinical heart dysfunction","volume":"35","author":"Cameli","year":"2019","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1007\/s10554-020-01768-x","article-title":"Evaluation of the Left Atrial Function by Two-Dimensional Speckle-Tracking Echocardiography in Diabetic Patients with Obesity","volume":"36","author":"Hosseinsabet","year":"2020","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.ihj.2018.06.019","article-title":"Detection of occult right ventricular dysfunction in young Egyptians with type 1 diabetes mellitus by two-dimensional speckle tracking echocardiography","volume":"70","author":"Ahmed","year":"2018","journal-title":"Indian Heart J."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.amjcard.2012.03.022","article-title":"Left atrial deformation analysis by speckle tracking echocardiography for prediction of cardiovascular outcomes","volume":"110","author":"Cameli","year":"2012","journal-title":"Am. J. Cardiol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1016\/j.echo.2010.06.023","article-title":"Impact of diastolic dysfunction grade on left atrial mechanics assessed by two-dimensional speckle tracking echocardiography","volume":"23","author":"Otani","year":"2010","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1016\/j.echo.2011.04.014","article-title":"Early detection of left atrial strain abnormalities by speckle-tracking in hypertensive and diabetic patients with normal left atrial size","volume":"24","author":"Mondillo","year":"2011","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1093\/ehjci\/jes084","article-title":"Changes in left atrial volume in diabetes mellitus: More than diastolic dysfunction?","volume":"13","author":"Kadappu","year":"2012","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1016\/j.ejheart.2008.08.012","article-title":"Left atrial velocity vector imaging for the detection and quantification of left ventricular diastolic function in type 2 diabetes","volume":"10","author":"Jarnert","year":"2008","journal-title":"Eur. J. Heart Fail."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1177\/1089253218799345","article-title":"Right Ventricular Function in Left Heart Disease","volume":"23","author":"Grecu","year":"2019","journal-title":"Semin. Cardiothorac. Vasc. Anesth."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"2001","DOI":"10.1093\/eurheartj\/ehq509","article-title":"Study Group on Biomarkers in Cardiology of the ESC Working Group on Acute Cardiac Care. Recommendations for the use of natriuretic peptides in acute cardiac care: A position statement from the Study Group on Biomarkers in Cardiology of the ESC Working Group on Acute Cardiac Care","volume":"33","author":"Thygesen","year":"2012","journal-title":"Eur. Heart J."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1007\/s00392-019-01531-w","article-title":"Passive leg-lifting in heart failure patients predicts exercise-induced rise in left ventricular filling pressures","volume":"109","author":"Tossavainen","year":"2020","journal-title":"Clin. Res. Cardiol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1002\/ejhf.1741","article-title":"How to diagnose heart failure with preserved ejection fraction: The HFA-PEFF diagnostic algorithm: A consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)","volume":"22","author":"Pieske","year":"2020","journal-title":"Eur. J. Heart Fail."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.jcmg.2019.01.037","article-title":"Diastolic Stress Test: Invasive and Noninvasive Testing","volume":"13","author":"Ha","year":"2020","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1080\/10255842.2016.1139093","article-title":"Left ventricular diastolic dysfunction in type 2 diabetes patients: A novel 2D strain analysis based on cardiac magnetic resonance Imaging","volume":"19","author":"Chen","year":"2016","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"404","DOI":"10.3904\/kjim.2016.208","article-title":"Diabetic cardiomyopathy: Where we are and where we are going","volume":"32","author":"Lee","year":"2017","journal-title":"Korean J. Intern. Med."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.jacc.2019.10.048","article-title":"Exercise Pulmonary Hypertension Predicts Clinical Outcomes in Patients With Dyspnea on Effort","volume":"75","author":"Ho","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"e002530","DOI":"10.1161\/JAHA.115.002530","article-title":"Diagnostic Accuracy of Tissue Doppler Index E\/e\u2019 for Evaluating Left Ventricular Filling Pressure and Diastolic Dysfunction\/Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis","volume":"5","author":"Sharifov","year":"2016","journal-title":"J. Am. Heart Assoc."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/S0735-1097(01)01333-X","article-title":"Assessment of flow velocity reserve by transthoracic Doppler echocardiography and venous adenosine infusion before and after left anterior descending coronary artery stenting","volume":"38","author":"Pizzuto","year":"2001","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.mric.2016.12.007","article-title":"Cardiac Applications of PET\/MR Imaging","volume":"25","author":"Lau","year":"2017","journal-title":"Magn. Reason. Imaging Clin. N. Am."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/S0002-9149(02)03153-3","article-title":"Usefulness of coronary flow reserve over regional wall motion when added to dual-imaging dipyridamole echocardiography","volume":"91","author":"Rigo","year":"2003","journal-title":"Am. J. Cardiol."},{"key":"ref_95","first-page":"436","article-title":"Usefulness of coronary flow reserve measured by transthoracic coronary Doppler ultrasound in the elderly","volume":"14","author":"Trifunovic","year":"2017","journal-title":"J. Geriatr. Cardiol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1111\/j.1540-8175.2012.01668.x","article-title":"Coronary flow reserve in patients with diabetes mellitus and prediabetes","volume":"29","author":"Atar","year":"2012","journal-title":"Echocardiography"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1016\/j.amjhyper.2007.08.005","article-title":"Determinants of reduction of coronary flow reserve in patients with type 2 diabetes mellitus or arterial hypertension without angiographically determined epicardial coronary stenosis","volume":"20","author":"Galderisi","year":"2007","journal-title":"Am. J. Hypertens."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1007\/s12350-013-9786-z","article-title":"Recent advances in metabolic imaging","volume":"20","author":"Gropler","year":"2013","journal-title":"J. Nucl. Cardiol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"e007483","DOI":"10.1161\/CIRCIMAGING.117.007483","article-title":"Clinical Outcome of Patients With Inducible Capillary Blood Flow Abnormalities During Demand Stress in the Presence or Absence of Angiographic Coronary Disease","volume":"11","author":"Kutty","year":"2018","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"4592","DOI":"10.1093\/eurheartj\/ehab282","article-title":"Clinical characteristics and prognosis of patients with microvascular angina: An international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group","volume":"42","author":"Shimokawa","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1161\/CIRCULATIONAHA.105.609990","article-title":"Women\u2019s Ischemia Syndrome Evaluation (WISE) Investigators. The economic burden of angina in women with suspected ischemic heart disease: Results from the National Institutes of Health--National Heart, Lung, and Blood Institute--sponsored Women\u2019s Ischemia Syndrome Evaluation","volume":"114","author":"Shaw","year":"2006","journal-title":"Circulation"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ijcard.2018.10.073","article-title":"Accuracy of non-invasive stress testing in women and men with angina in the absence of obstructive coronary artery disease","volume":"282","author":"Pargaonkar","year":"2019","journal-title":"Int. J. Cardiol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.echo.2009.11.023","article-title":"Characteristics and outcomes of patients with abnormal stress echocardiograms and angiographically mild coronary artery disease (<50% stenoses) or normal coronary arteries","volume":"23","author":"From","year":"2010","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Al-Mohaissen, M.A. (2022). Echocardiographic assessment of primary microvascular angina and primary coronary microvascular dysfunction. Trends Cardiovasc. Med., online ahead of print.","DOI":"10.1016\/j.tcm.2022.02.007"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1161\/CIRCIMAGING.109.860593","article-title":"Radionuclide imaging of myocardial metabolism","volume":"3","author":"Peterson","year":"2010","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"299","DOI":"10.2967\/jnumed.119.226498","article-title":"First Human Imaging Studies with the EXPLORER Total-Body PET Scanner","volume":"60","author":"Badawi","year":"2019","journal-title":"J. Nucl. Med."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1186\/s12933-019-0940-z","article-title":"Phenotyping diabetic cardiomyopathy in Europeans and South Asians","volume":"18","author":"Paiman","year":"2019","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.echo.2014.01.001","article-title":"Longitudinal myocardial strain alteration is associated with left ventricular remodeling in asymptomatic patients with type 2 diabetes mellitus","volume":"27","author":"Ernande","year":"2014","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"685","DOI":"10.4239\/wjd.v12.i6.685","article-title":"Role of novel biomarkers in diabetic cardiomyopathy","volume":"12","author":"Kumric","year":"2021","journal-title":"World J. Diabetes"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1080\/15548627.2015.1051295","article-title":"Autophagic adaptations in diabetic cardiomyopathy differ between type 1 and type 2 diabetes","volume":"11","author":"Kanamori","year":"2015","journal-title":"Autophagy"},{"key":"ref_111","doi-asserted-by":"crossref","unstructured":"H\u00f6lscher, M.E., Bode, C., and Bugger, H. (2016). Diabetic Cardiomyopathy: Does the Type of Diabetes Matter?. Int. J. Mol. Sci., 17.","DOI":"10.3390\/ijms17122136"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"755","DOI":"10.4070\/kcj.2018.0164","article-title":"Diastolic Stress Echocardiography to Quantify the Response of Diastolic Functional Indices to Dynamic Exercise in Abnormal Relaxation: Unmasking Diastolic Abnormalities is Getting Ready for Prime Time","volume":"48","author":"Ha","year":"2018","journal-title":"Korean Circ. J."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1093\/ehjci\/jew190","article-title":"The clinical use of stress echocardiography in non-ischaemic heart disease: Recommendations from the European Association of Cardiovascular Imaging and the American Society of Echocardiography","volume":"17","author":"Lancellotti","year":"2016","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"50","DOI":"10.4103\/0975-3583.78597","article-title":"Comparison of left ventricular mass in normotensive type 2 diabetes mellitus patients with that in the nondiabetic population","volume":"2","author":"Santra","year":"2011","journal-title":"J. Cardiovasc. Dis. Res."},{"key":"ref_115","first-page":"1031","article-title":"Echocardiographic reference ranges for normal cardiac Doppler data: Results from the NORRE Study","volume":"16","author":"Caballero","year":"2015","journal-title":"Eur. Heart J. Cardiovasc. Imaging"}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/10\/2\/46\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:16:38Z","timestamp":1760120198000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/10\/2\/46"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,26]]},"references-count":115,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["jcdd10020046"],"URL":"https:\/\/doi.org\/10.3390\/jcdd10020046","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,26]]}}}