Difficulties in the inclusion of patients with cardiacly asymptomatic type 2 diabetes and with at least two cardiovascular risk factors.

The pathophysiological features of myocardial diabetic subject combined with cardiac autonomic neuropathy were behind the quietness of myocardial ischemia, known as silent myocardial ischemia (IMS). These patients have the risk to remain asymptomatic until the sudden onset of a myocardial infarction, or even sudden death.

That is why the investigators want to evaluate the contribution of non-invasive tools to stand in the diagnosis of IMS patients with diabetes type 2, asymptomatic heart on map: Technical myocardial speckle tracking in studying strains overall average left ventricular (longitudinal, circumferential and radial) measured in 2D and 3D at rest, compared to stress echocardiography with dobutamine (ESD)

Inclusion Criteria:

• With at least two cardiovascular risk factors including: hypertension, dyslipidemia, smoking active or interrupted for less than 3 years, family history (relatives of the 1st degree) Accident major CV before 60.
• Or whatever the level of risk factors: peripheral artery disease and / or carotid atherosclerosis, or proteinuria

Exclusion Criteria:

• Valvular heart disease (severe to moderate valvular ) , hypertrophic , dilated , chronic lung
• History of cardiotoxic chemotherapy
• Atrioventricular blocks of degree
• Asthma
• Recent stroke within a month
• Bilateral carotid stenosis tight
• Glaucoma untreated narrow angle
• Subject to exclusion period (determined by a previous study or in progress)
• Inability to give informed about information
• patient under judicial protection
• patient guardianship or curatorship
• Current pregnancy (women of childbearing age )
• Breastfeeding

Subjects with type 2 diabetes, men or women, asymptomatic on the heart level, high risk