Evaluation of Cardiac, Autonomic Functions in Ambulant Patients with Duchenne Muscular Dystrophy.
Amritharekha NayakApoorva S BMainak BardhanR RashmiG ArunachalP V PrathyushaAtchayaram NaliniT N SathyaprabhaKaviraja UdupaPublished in: SN comprehensive clinical medicine (2023)
Duchenne muscular dystrophy (DMD) is an X-linked genetic disorder caused by dystrophin gene mutation resulting in muscle weakness, motor delays, difficulty in standing, and inability to walk by 12 years. As disease progresses, it leads to cardiac and respiratory failure. Evaluation of cardiac autonomic status and echocardiography in DMD patients at a young age can be a potential biomarker to assess disease progression. This study aimed to investigate the younger DMD population of 5-11years of age with mild to moderate cardiac involvement for early detection using non-invasive and cost-effective tools. Genetically confirmed male DMD patients, aged 5-11 years ( n = 47), screened from the outpatient department of a tertiary neuroscience institution were subjected to heart rate variability and echocardiographic analysis, and values were correlated with their clinical variables. DMD patients showed a significantly higher difference in HR, interventricular septum, E m/s, and E-wave to A-wave (E/A) ratio than normal values ( p < 0.001). Significantly higher HR indicates initial sinus tachycardia and decreased IVD (d), and increased E m/s and E/A ratio mark the onset of cardiac symptoms in DMD patients even though its chamber dimension remains normal and are associated with cardiac muscle fibrosis.
Keyphrases
- duchenne muscular dystrophy
- left ventricular
- end stage renal disease
- heart rate variability
- muscular dystrophy
- ejection fraction
- newly diagnosed
- chronic kidney disease
- heart rate
- skeletal muscle
- prognostic factors
- heart failure
- peritoneal dialysis
- computed tomography
- patient reported outcomes
- cardiac resynchronization therapy
- tertiary care
- middle aged
- dna methylation
- respiratory failure
- children with cerebral palsy
- blood pressure