Central arterial wave reflection in Duchenne muscular dystrophy: Potential effects of ambulation and corticosteroid treatment

Duchenne muscular dystrophy (DMD) is a rare X-linked genetic disorder caused by mutations in the dystrophin gene, leading to progressive muscle wasting and loss of ambulation. While corticosteroids improve non-cardiac outcomes like skeletal muscle function, dilated cardiomyopathy remains the leading cause of death in patients with DMD. The absence of dystrophin in arterial smooth muscle and the endothelium suggests that peripheral arterial dysfunction may contribute to cardiovascular (CV) complications in DMD. Elevated central arterial wave reflection has been observed in boys with DMD, potentially increasing left ventricular load. This preliminary analysis examined the effects of ambulation status and corticosteroid treatment duration on central arterial wave reflection in boys with DMD. HYPOTHESIS: We hypothesized that participants that were non-ambulatory or had longer corticosteroid treatment duration would have elevated central arterial wave reflection. METHODS: Peripheral pressure waveforms were recorded in boys (n=34, 13±4 years) with DMD using an oscillometric cuff device. Central pressure waveforms were derived through a generalized transfer function to calculate augmentation index (AIx) and reflection magnitude (RM). Ambulation status was assessed using the DMD Functional Ability Self-Assessment Tool, and corticosteroid treatment duration was dichotomized based on a median split: short (< 6 years) and long (≥6 years). RESULTS: Non-ambulatory boys with DMD had significantly higher AIx (32.9 ± 15.5% vs 10.8 ± 14.6%, p< 0.001) and RM (61.1 ± 10.4% vs 48.2 ± 6.6%, p< 0.001) compared to their ambulatory counterparts. Boys with longer corticosteroid treatment duration had lower RM (50.7 ± 9.1% vs. 58.1 ± 7.1%, p=0.048), as well as a non-significant trend towards lower AIx (14.6 ± 20.8% vs. 27.8 ± 14.5%, p=0.097) compared to those with shorter treatment durations. CONCLUSION: This preliminary analysis suggests that non-ambulatory status may exacerbate arterial load whereas long-term corticosteroid treatment may have a positive effect on these parameters. These findings underscore the need for larger longitudinal studies to explore therapies that enhance peripheral circulation and minimize CV risk in this population, particularly in non-ambulatory boys. Additionally, the long-term arterial benefits of corticosteroid treatment regimens, including duration and frequency, should be investigated further. Supported by NIH1R01HLI55764 (MW) and AHA 24IAUST1199297 (GM). This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.