Background:Hyperglycemia is associated with changes in cardiac structure and function, increased atherosclerosis and diabetic cardiomyopathy (1,2). Currently there is scarcity of robust large scale studies evaluating prevalence of asymptomatic left ventricular dysfunction and/or pre-clinical Heart Failure (HF) in patients with T2DM, particularly in India. Therefore, this study was conducted to determine prevalence of pre-clinical cardiomyopathy in Indian patients with T2DM.Methodology:Cross sectional, multi-center study was conducted in India. Institutional ethics committee had approved study protocol. Patients aged ≥ 18 years, T2DM with duration of ≥1 year and willing to provide informed consent were included. Patients with coronary artery or valvular disease, previously diagnosed with HF stage III/IV, chronic kidney disease, peripheral artery disease, arrhythmias, diabetes other than T2DM or currently under treatment with digoxin or loop diuretics were excluded. Two-dimensional echocardiography and natriuretic peptide estimation were conducted.Results:This is an interim analysis of 569 patients. Mean HbA1c was 8.3%. Total subjects with LVD were 52% (95% CI 0.48,0.56). Diastolic dysfunction was 20% (95% CI 0.17,0.24) and systolic dysfunction was 42% (95% CI 0.38,0.46) (Table 1). Prevalence of HF according to BNP levels >105 pg/ml was 9% (95% CI 0.07,0.11). Correlation analysis between HbA1c and prevalence of LVD was statistically significant for systolic LVD, while it was not statistically significant for diastolic LVD. Patients in the age group of 51 to 60 were more vulnerable to LVD at 35% (95% CI 0.30,0.41).Conclusion:Using suitable echocardiographic indexes and laboratory investigations LVD is detectable in almost half of the T2DM patients and has a direct correlation with older age and HbA1c. Thus, we conclude that HF goes undetected and early intervention to diagnose and treat LVD can improve outcome.