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What are the predictors of early left ventricular systolic dysfunction detected by myocardial strain imaging in Duchenne muscular dystrophy patients?
What are the predictors of early left ventricular systolic dysfunction detected by myocardial strain imaging in Duchenne muscular dystrophy patients?
Myocardial strain measurements via echocardiography can detect early left ventricular systolic dysfunction in DMD patients, which is associated with older age, corticosteroid use, and specific gene mutations.
May inform risk-stratified strain surveillance in DMD; hypothesis-generating for mutation-specific progression and therapy effects.
INTRODUCTION: Early detection of left ventricular systolic dysfunction (LVSD) is important for therapeutic strategies for Duchenne muscular dystrophy (DMD) patients. We analyzed myocardial strain using echocardiography for early detection of LVSD and determined the predictors of early LVSD. METHODS: This investigation was a cross-sectional study of 40 DMD patients with normal left ventricular ejection fraction. Global longitudinal strain (GLS) was used to analyze subtle disturbances in longitudinal contraction of the myocardium. Patients were determined to have early LVSD (GLS > -18) or normal left ventricular systolic function (GLS ≤ -18). RESULTS: Patients who had early LVSD were older and had a higher frequency of corticosteroid therapy and of mutations in exons 45, 46, 47, 48, 49, 50, and 52. DISCUSSION: Myocardial strain measurements are useful for the early diagnosis of LVSD in DMD patients. Older age, use of corticosteroids, and mutations within the "hot-spot" region of the DMD gene are associated with early LVSD. Muscle Nerve, 2018.
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Cirino et al. (2018) studied this question.
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