Assessment of Left Ventricular Doppler Derived Myocardial Performance Index in Diabetic patients with Albuminuria.

INTRODUCTION : India has highest percentage of diabetic population in the world. The complications of diabetes increases with the duration of diabetes and the level of glycemic control. Albuminuria is one of the early indicator of microangiopathy.Diabetic patients predicts the cardiovascular dysfunction when it is associated with micro Albuminuria. Albuminuria judge mainly diabetic kidney disease in people with type II Diabetes mellitus, and can also one of a critical judge of all-cause death, mainly from cardiac causes. The reason of the correlation of albumin uria with heart disease is in doubt, it is mainly due the coronary vascular and structural alteration (raise endothelial permeability, cholesterol accumulation , blood clot production) that causes kidney problems can be associated with in the heart structures and, thus, contribute to heart failure. Various critical Studies have shown there is link between micro Albuminuria and atherothrombotic disease but also other confounding factors needs to be ruled out. The presence of a unique feature called diabetics cardio myopathy may lead to increase in cardiac disease and death in diabetic population. AIMS AND OBJECTIVES : To assess the echo car idiographic index like IVS & posterior wall thickness, L.Ventricle functions, E wave flow velocity Decel eration time ;mitral inflow velocity ratio between E and A wave;fr actional shortening and LV ejection index ;time of LV emptying (ejection time) ;time during isovolumic contraction (IV C T); time during isovolumic relaxation (IV R T);thickness of IV S; left atrium dimension; left ventricle dimension during diastolic;L V MI(left ventricle mass and index); left ven tricle dimension during systolic ); thickness of posterior wall. To determine the cardiac function in diabetic patient with Albuminuria and those patient without Albuminuria without obvious previous heart disease using the TEI INDEX and to compare this index with other usual method which are used to assess the cardiac function. CONCLUSION : There is clear-cut positive correlation between the LEFT VENTRICULAR TEI INDEX and the degree Albuminuria in diabetics. LV TEI INDEX can be a useful marker in early detection of cardiac dysfunction in diabetic patients and helps to prognosticate the diabetic population. LV Tei index is an early parameter to observe the ventricular dysfunction before it can be detected by conventional echocardiography parameters. This index increases in stepwise pattern in diabetic population depending upon the duration of DM and diabetic complications