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Introduction. Several cardiovascular manifestations in patients with diabetes may be asymptomatic. Left ventricular diastolic dysfunction (LVDD) is considered to be the earliest metabolic myocardial lesion in these patients, and can be diagnosed with tissue Doppler echocardiography. Silent myocardial ischemia (SMI) is a characteristic and frequently described form of ischemic heart disease in patients with diabetes. Objective. The aim of the study was to assess the prevalence of LVDD and SMI in patients with type 2 diabetes, as well as to compare demographic, clinical, and metabolic data among defined groups (patients with LVDD, patients with SMI and patients with type 2 diabetes, without LVDD and SMI). Methods. We investigated 104 type 2 diabetic patients (mean age 55.4±9.1 years, 64.4% males) with normal blood pressure, prehypertension and arterial hypertension stage I. Study design included basic laboratory assessment and cardiological workup (transthoracic echocardiography and tissue Doppler, as well as the exercise stress echocardiography). Results. LVDD was diagnosed in twelve patients (11.5%), while SMI was revealed in six patients (5.8%). Less patients with LVDD were using metformin, in comparison to other two groups (χ2 =12.152; p=0.002). Values of HDL cholesterol (F=4.515; p=0.013) and apolipoprotein A1 (F=5.128; p= 0.008) were significantly higher in patients with LVDD. Conclusion. The study confirmed asymptomatic cardiovascular complications in 17.3% patients with type 2 diabetes.

The role of insulin sensitivity (IS), as well as the association of IS with fibrinolysis impairment, in the occurrence of ischemic stroke, has not been clarified. The study was aimed to analyze IS, plasma insulin (PI) and plasminogen activator inhibitor (PAI)-1 levels in 34 type 2 diabetics (T2D) with ischemic stroke (group A), 30 T2D without ischemic stroke (group B), 33 nondiabetics with ischemic stroke (group C) and 33 healthy controls (group D). Ischemic stroke was confirmed by clinical and neuroimaging criteria. IS levels were determined by the minimal model analysis (Si index). Plasma insulin levels were measured by radioimmunoassay and PAI-1 activity was performed by the plasminogen chromogenic plasmin substrate assay. We found that Silevels were significantly lower in group A vs. B (1.17+/-0.66 vs. 2.79+/-0.62 min-1/mU/Lx104; p