الفهرس 
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Abstract
Diabetes is a risk factor for the development of symptomatic heart failure, particularly in elderly patients with type 2 diabetes (Nichols et al., 2001).
Heart failure that occurs as the result of impaired.myocardial relaxation and compliance has been termed diastolic heart failure (Vasan and Levy, 2000).
Diastolic heart failure develops despite normal left ventricular systolic contractile function and leads to significant morbidity, medical costs, and mortality. Typically, patients with type 2 diabetes who are symptomatic from diastolic heart failure have superimposed hypertension, coronary artery disease, left ventricular hypertrophy, atrial fibrillation, or renal insufficiency (Piccini et al., 2004).
Alterations in diastolic function are also frequently observed in asymptomatic individuals with type 1 diabetes, although their contribution to the development of clinical heart failure later in life remains uncertain (Fraser et al., 1995).
The aim of this study was to determine whether echocardiographic signs of diastolic or systolic dysfunction are already present in diabetic children and adolescents, a population in whom comorbidity such as ischemic heart disease or hypertension can be considered as absent or minimal. Additionally, we evaluated the role of tissue Doppler imaging, where velocities of the myocardium itself are measured as a screening tool for these abnormalities.