Quantitative assessment of left ventricular longitudinal function and myocardial deformation in Duchenne muscular dystrophy patients

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Authors	PANOVSKÝ Roman PEŠL Martin MÁCHAL Jan HOLEČEK Tomáš FEITOVÁ Věra JUŘÍKOVÁ Lenka MASÁROVÁ Lucia PEŠLOVÁ Eva OPATŘIL Lukáš MOJICA-PISCIOTTI Mary Luz KINCL Vladimír
Year of publication	2021
Type	Article in Periodical
Magazine / Source	Orphanet Journal of Rare Diseases
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://ojrd.biomedcentral.com/articles/10.1186/s13023-021-01704-9
Doi	http://dx.doi.org/10.1186/s13023-021-01704-9
Keywords	Cardiac magnetic resonance; Duchenne muscular dystrophy; Feature tracking; Strain analysis
Description	BackgroundDuchenne muscular dystrophy (DMD) manifests in males mainly by skeletal muscle impairment, but also by cardiac dysfunction. The assessment of the early phases of cardiac involvement using echocardiography is often very difficult to perform in these patients. The aim of the study was to use cardiac magnetic resonance (CMR) strain analysis and mitral annular plane systolic excursion (MAPSE) in the detection of early left ventricular (LV) dysfunction in DMD patients. Methods and resultsIn total, 51 male DMD patients and 18 matched controls were examined by CMR. MAPSE measurement and functional analysis using feature tracking (FT) were performed. Three groups of patients were evaluated: A/ patients with LGE and LV EF<50% (n=8), B/ patients with LGE and LVEF50% (n=13), and C/ patients without LGE and LVEF >= 50% (n=30). MAPSE and global LV strains of the 3 DMD groups were compared to controls (n=18). Groups A and B had significantly reduced values of MAPSE, global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) in comparison to controls (p<0.05). The values of MAPSE (11.61.9 v 13.72.7 mm) and GCS (- 26.2 +/- 4.2 v - 30.0 +/- 5.1%) were significantly reduced in group C compared to the controls (p<0.05).Conclusion DMD patients had decreased LV systolic function measured by MAPSE and global LV strain even in the case of normal LV EF and the absence of LGE. FT and MAPSE measurement provide sensitive assessment of early cardiac involvement in DMD patients.