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Background: While lipotoxiticy have been reported to play an important role in the pathogenesis of the diabetes (DM), the association of fatty liver, phenotype of lipotixicity to liver, and cardiac dysfunction has not been fully determined. The aim of this study was to investigate the cardiac function by measuring longitudinal strain (LS), which was the early marker for heart failure with preserved ejection fraction.Methods: Seventy-four DM patients underwent two-dimensional speckle tracking echocardiography and screened for diabetic complications including abdominal echo. Twenty four healthy control were also enrolled.Results: HbA1c was 10±2 % in DM, and 85% were type II DM. Thirty (41%) DM patients (FL-DM) with fatty liver, remaining 39 patients (53%) (noFL-DM) were not. LS was significantly deteriorated in FL-DM than in noFL-DM or control (-13±3 vs. -16±3, vs. -17±3, p=0.01, p<0.01), whereas the ejection fraction or BNP level showed no difference. In all DM patients, LS significantly correlated with body mass index (R=0.49, p<0.01), body weight (R=0.41, p<0.01), systolic blood pressure (R=0.36, p<0.01), diastolic blood pressure (R=0.28, P=0.02), LDL/HDL ratio (R=0.27, p=0.03).Conclusion: Poorly controlled diabetes with fatty liver showed longitudinal systolic dysfunction with preserved LVEF and normal BNP level. Its correlation with the obesity and dyslipidemia suggests that the lipotoxiciticy may play an important role in the subclinical myocardial contractile dysfunction in diabetic patients.