Abstract 20184: Cardiac MRI Feature Tracking in Duchenne Muscular Dystrophy Patients More Frequently Demonstrates Decreased Myocardial Strain Associated With Late Gadolinium Enhancement Positive Segments Compared to Echocardiographic Speckle Tracking
Introduction: Duchenne muscular dystrophy (DMD) is an inherited X-linked disorder with an incidence of 1 in 3,500 male births and cardiomyopathy is becoming the leading cause of death. While Cardiac MRI (CMR) and late gadolinium enhancement (LGE) are important tools in recognizing myocardial involvement, myocardial strain imaging may demonstrate early changes and allow patients to avoid gadolinium contrast.
Methods: We performed CMR feature tracking (FT) and echo based speckle tracking (ST) strain measures on DMD patients and age/sex matched controls who had received a CMR with contrast and transthoracic echocardiogram. Data was collected for longitudinal strain/strain rate in the apical 4 chamber view and circumferential strain/strain rate in the mid-papillary parasternal short axis. Segmental wall analysis was performed and compared with the presence of LGE. Data was analyzed using student’s t-test and one-way ANOVA adjusting for multiple comparisons.
Results: We measured 22 subjects with DMD (mean age 14; EF 57%) and 9 controls (mean age 14; EF 59%). In 12 of 22 subjects with DMD LGE was positive only in the lateral segments in short axis. Average circumferential strain (CS) measured by FT was significantly decreased in DMD compared to controls (-18.6±6 vs. -25.1±3; p<0.001) and showed significant differences in the mid-lateral, mid-posterior and mid-inferior segments. Average CS by ST trended towards significance (p=0.06) but showed significance in only the mid-inferior segment. FT showed significant differences in the mid-posterior segment between LGE positive (-14.2±8) and LGE negative (-18.6±9) in DMD subjects compared to controls (-29.4±7; p≤0.02). FT showed significant differences between mid-anteroseptal and mid-posterior segments within LGE positive (p<0.003) and negative (p<0.02) DMD subjects. There were no significant differences in longitudinal strain/strain rate and circumferential strain rate.
Conclusions: CMR FT derived myocardial strain was better than ST in demonstrating differences between subjects with DMD and controls. FT was also able to demonstrate differences in LGE positive and negative segments within patients with DMD. FT may be able to predict LGE positive segments in DMD without the use of gadolinium contrast.
Author Disclosures: B. Siegel: None. L. Olivieri: None. H. Gordish-Dressman: None. C. Spurney: None.
- © 2016 by American Heart Association, Inc.