Key result
Prednisolone use in boys with Duchenne Muscular Dystrophy was associated with heart rate variability comparable to healthy controls, whereas Deflazacort use was associated with lower HRV.
Why the study?
Individuals with Duchenne Muscular Dystrophy (DMD) have cardiac autonomic impairment, prompting investigation into how therapy with Prednisone/Prednisolone versus Deflazacort influences cardiac autonomic modulation compared with no corticoid use and typically developed controls.
Does the type of corticosteroid (Prednisone/Prednisolone vs Deflazacort) affect heart rate variability in boys with Duchenne Muscular Dystrophy?
Cross-Sectional (n=40)
Does the type of corticosteroid (Prednisone/Prednisolone vs Deflazacort) affect heart rate variability in boys with Duchenne Muscular Dystrophy?
Prednisone/Prednisolone, but not Deflazacort, appears to preserve cardiac autonomic modulation (heart rate variability) in boys with Duchenne Muscular Dystrophy.
Autonomic monitoring may inform DMD management; leaves open differential corticosteroid effects on HRV.
Individuals with Duchenne Muscular Dystrophy (DMD) have an impairment of cardiac autonomic function categorized by parasympathetic reduction and sympathetic predominance. The objective of this study was to assess the cardiac autonomic modulation of individuals with DMD undergoing therapy with Prednisone/Prednisolone and Deflazacort and compare with individuals with DMD without the use of these medications and a typically developed control group. Methods: A cross-sectional study was completed, wherein 40 boys were evaluated. The four treatment groups were: Deflazacort; Prednisone/Prednisolone; no corticoid use; and typical development. Heart Rate Variability (HRV) was investigated via linear indices (Time Domain and Frequency Domain) and non-linear indices Results: The results of this study revealed that individuals with DMD undertaking pharmacotherapies with Prednisolone demonstrated HRV comparable to the Control Typically Developed (CTD) group. In contrast, individuals with DMD undergoing pharmacotherapies with Deflazacort achieved lower HRV, akin to individuals with DMD without any medications, as demonstrated in the metrics: RMSSD; LF (n.u.), HF (n.u.), LF/HF; SD1, α1, and α1/α2, and a significant effect for SD1/SD2; %DET and Ratio; Shannon Entropy, 0 V%, 2 LV% and 2 ULV%. Conclusions: Corticosteroids have the potential to affect the cardiac autonomic modulation in adolescents with DMD. The use of Prednisone/Prednisolone appears to promote improved responses in terms of sympathovagal activity as opposed to Deflazacort.
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Dias et al. (2021) conducted a cross-sectional in Duchenne Muscular Dystrophy (n=40). Corticosteroids (Prednisone/Prednisolone and Deflazacort) vs. No corticoid use and typically developed controls was evaluated on Heart Rate Variability (HRV) linear and non-linear indices. Prednisolone use in boys with Duchenne Muscular Dystrophy was associated with heart rate variability comparable to healthy controls, whereas Deflazacort use was associated with lower HRV.
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