The Role of Systemic Inflammatory Indices in Predicting Cardiovascular Involvement in Children with Duchenne Muscular Dystrophy

Background: Duchenne Muscular Dystrophy (DMD) is an X-linked recessive neuromuscular disorder that leads to progressive muscle weakness and cardiomyopathy, with cardiovascular complications being a primary cause of morbidity and mortality. Recent interest has emerged in the role of systemic inflammatory indices as potential predictors of cardiovascular involvement. This study aimed to evaluate the prognostic value of inflammatory markers—NLR, PLR, MLR, SIRI, SII, and PIV—in children with DMD and to explore their association with cardiac findings. Methods: In this retrospective study, 25 male patients diagnosed with DMD and 25 age-matched healthy male controls were evaluated between January 2021 and July 2024. Demographic and clinical data, hematologic and biochemical parameters, and inflammatory indices were recorded. Cardiovascular involvement was assessed using electrocardiography (ECG) and transthoracic echocardiography (TTE). Group comparisons were conducted using independent t-tests, while ROC and Pearson correlation analyses were used for diagnostic performance and associations. Results: Pathological Q waves were the most frequent ECG abnormality (24%), and 16% of patients had echocardiographic abnormalities. While most systemic inflammatory indices (NLR, MLR, SIRI, SII, PIV) did not significantly distinguish cardiovascular involvement, PLR demonstrated a strong positive correlation with Pro-BNP levels (r = 0.86, p < 0.05), suggesting a potential link between systemic inflammation and subclinical cardiac stress. Conclusions: Although the overall diagnostic utility of inflammatory indices in predicting cardiovascular complications in DMD was limited, PLR emerged as a promising marker. Its significant correlation with Pro-BNP highlights its potential role in identifying early cardiovascular risk, warranting further investigation in prospective studies.