ASSESSMENT OF EPICARDIAL ADIPOSE TISSUE AND LEFT VENTRICULAR PERFORMANCE INTERACTION IN TYPE 2 DIABETES MELLITUS USING 2D SPECKLE-TRACKING ECHOCARDIOGRAPHY

Background: Type 2 Diabetes Mellitus (T2DM) is a major risk factor for diabetic cardiomyopathy, often presenting with subclinical left ventricular (LV) dysfunction before overt heart failure. Epicardial adipose tissue (EAT), a metabolically active fat depot, is increasingly implicated in cardiac dysfunction. Aim: To assess the interaction between EAT thickness and LV performance in patients with T2DM using 2D speckle-tracking echocardiography (2D-STE). Methods: An Observational study was conducted on T2DM patients. Participants were stratied based on global longitudinal strain (GLS) into two groups: those with preserved systolic function (GLS ≥18%) and those with impaired systolic function (GLS <18%). All subjects underwent comprehensive echocardiography, including 2D-STE for GLS measurement and standard 2D echocardiography for assessing LV structure, diastolic function, and EAT thickness. Results: The mean & SD of age among our participants is 47.5 ± 12.7 years. Patients with impaired GLS (GLS <18%) had a signicantly longer duration of diabetes, higher HbA1c and BMI compared to those with preserved GLS. The impaired GLS grouphad signicantly lower LVEF (58.3% vs. 61.6%, p=0.0001), elevated LV lling pressures (E/e' 13.3 vs. 10.13, p=0.0001), and altered diastolic lling (E/A 1.28 vs. 1.14, p=0.0006). Crucially, EAT thickness was signicantly greater in the impaired GLS group (6.46 mm vs. 4.36 mm, p=0.0001). Conclusion: GLS is signicantly impacted by LV systolic and diastolic dysfunction, with increased EAT thickness linked to impaired GLS, suggesting a potential link between pericardial fat and diabetic cardiomyopathy.