Diastolic dysfunction is the most prevalent form of myocardial abnormalities associated with type 2 diabetes and metabolic syndrome. This review presents the pathophysiology, diagnostic modalities, therapeutic implications, clinical applications and problems associated with diastolic dysfunction. There is no question that this condition is highly prevalent in individuals with metabolic syndrome (35%), prediabetes and type 2 diabetes (50%) and coronary heart disease (60%). For patients, diastolic dysfunction translates into impaired quality of life induced by the deterioration in exercise capacity that limits daily living activities. It results from abnormal myocardial active relaxation and an increase in passive stiffness due to metabolic derangements and structural remodelling. Diastolic dysfunction associated with the metabolic syndrome or diabetes is not always detected early since it requires more sensitive imaging techniques than the traditional one used routinely. Tissue Doppler imaging is required to detect and quantify diastolic dysfunction. It has been reported that pharmacological glucose-lowering therapy as well as lifestyle modification can improve diastolic dysfunction. Therefore, early detection of diastolic dysfunction in patients with metabolic syndrome and type 2 diabetes could help optimize their clinical management and prevent heart failure.
Documentation centre