الفهرس 
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Abstract
1.The current study showed that there was no statistically significant difference regarding to age between both groups. 2. Our study revealed that there was no statistically significant difference between both groups regarding to smoking, family history and hypertension. 3. In the current study, the echocardiographic results showed significant change in LA diameter in prediabetic group to normal subjects P<0.001. Also assessment of the diastolic function with the pulsed Doppler sample volume was positioned at the mitral leaflet tips showed A wave, IVRT, ET and DT were significantly longer whereas E wave and E/A ratio were significantly lower in preDM group than in controls. 4. The lateral and septal wall Pulse-wave tissue Doppler echocardiographic results of the subjects showed that Sm, Em and Em/Am ratio were significantly lower but IVRTm, IVCTm, IVCTm/ETm, E/Em ratio and MPI values were significantly higher in patient group. Conclusion and Recommendations: Conclusion: The results of our study demonstrated that there is both systolic and diastolic subclinical left ventricular dysfunction in prediabetic patients. TDE is especially important in detecting the early subclinical LV systolic and diastolic dysfunction at this group of patients and its subgroups. For that reason, utilization of TDE during conventional echocardiographic measurements of prediabetic patients may have prognostic significance. These early abnormalities observed in LV function may explain the increased morbidity and mortality seen in patients with preDM. However, the clinical significance of our findings remains to be determined with larger scale studies. Recommendations: Use of global longitudinal strain (GLS) measured by 2-dimensional longitudinal speckle tracking echocardiography may be a more sensitive measure of left ventricular function than conventional LV ejection fraction (EF), and more useful than MPI. Limitations of the study: There are some limitations of our study. First, the coronary artery disease was ruled out based on the history, physical examination, electrocardiography and echocardiography. The more precise imaging modalities like myocardial perfusion scintigraphy, conventional angiography or computed tomography angiography were not performed. Therefore, there may be subjects with CAD in our study population. Second, the relatively small number of patients included in this study prevents the generalization of these results to all prediabetic patients and made difficult to perform subgroup analysis. Third, tissue Doppler echocardiography measurements are angle dependent and therefore the values obtained through this method may be influenced by that limitation.