Diabetic patients are at an increased risk of developing heart failure. The aetiology of diabetic heart disease is likely to be multifactorial, ranging from altered myocardial metabolism, increased interstitial fibrosis, endothelial dysfunction, microvascular disease, and coronary atherosclerosis. These factors act synergistically with resultant myocardial systolic and diastolic dysfunction. The aim of the present review is to illustrate the role of multimodality cardiac imaging such as echocardiography, nuclear imaging, computed tomography, and magnetic resonance imaging in providing insights into these pathological processes, and to quantify the extent of myocardial diastolic and systolic dysfunction.
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