Abstract 8915: Utility of Transmural Myocardial Strain Profile to Predict Early Left Ventricular Dysfunction in Patients with Duchenne Muscular Dystrophy
Background: Myocardial damage in Duchenne muscular dystrophy (DMD) leads to lethal outcome. Therefore, early detection of myocardial changes in DMD is important because earlier treatment might help to prevent the development of myocardial fibrosis. Transmural myocardial strain distribution can be obtained as a form of transmural strain profile using myocardial tissue Doppler strain imaging. Accordingly, the aim of this study was to test the hypothesis that transmural strain profile (TMSP) analysis can predict future left ventricular (LV) dysfunction in DMD patients with preserved ejection fraction (EF).
Methods: We studied 57 consecutive DMD patients who did not have LV wall motion abnormality; EF 60±7% (all ≥ 55%), aged 11±3 years. Echocardiography was performed at baseline and 1-year follow-up. TMSP was evaluated in the posterior wall from mid-LV short-axis view (Aplio-XG Toshiba Corp.).
Results: Thirty-seven patients (65%) had normal TMSP pattern (Group 1), and the remaining 20 patients (35%) were classified as TMSP with a notch (Group 2). The peak strain value in the posterior wall and EF were similar between two groups. Of 20 patients in Group 2, 8 patients (40%) had wall motion abnormality in the posterior wall at 1-year follow-up. On the other hand, no patient in Group 1 had wall motion abnormality at 1-year follow-up (p<0.001 vs. Group 2).
Conclusions: Subclinical LV dysfunction can be detected with TMSP in DMD patients who do not have wall motion abnormalities by conventional echocardiography. TMSP with notch was useful at evaluating early subtle changes in DMD patients, and may be useful for predicting future LV dysfunction.
- © 2011 by American Heart Association, Inc.