Early diastolic impairment of diabetic heart: the significance of right ventricle.

We read with great interest the study by Karamitsos et al. the methods and interpretation of the results, however, raise several concerns: 1. Are the LVMI higher in patients with type 1 diabetes mellitus than controls? If yes, do patients with type 1 diabetes mellitus and normal LVMI have impaired diastolic function? 2. Is the significant alteration of left and right ventricular diastolic function by tissue Doppler echocardiography in patients with type 1 diabetes mellitus in this study caused by the higher level of glycemia, or is tissue Doppler echocardiography sensitive enough to evaluate early alteration of cardiac function in patients with type 1 diabetes? Therefore, we think that further studies about left and right ventricular systolic and diastolic functions when glycemic control improves and aggravates are needed.