Assessment of global longitudinal strain can effectively help monitor myocardial involvement in patients with Duchenne muscular dystrophy (DMD), even in the early stages of left ventricular (LV) systolic dysfunction, Brazilian researchers reported in a new study.

LV systolic dysfunction is common among young patients with DMD, the research team confirmed. It is known that DMD causes cardiomyopathy, which gets worse with age. 

“In addition to traditional parameters such as [ejection fraction], assessment of [global longitudinal strain] was useful in the monitoring of myocardial involvement in DMD, including patients in early stages of LV systolic dysfunction,” the authors of the study wrote. 


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The results were presented as a poster at the 2022 Muscular Dystrophy Association Clinical & Scientific Conference held between March 13 and March 16, 2022, in Nashville, Tennessee, and online.

Read more about cardiac complications in muscular dystrophy.

In order to confirm LV dysfunction related to age and describe the global longitudinal strain profile of DMD patients, the team of researchers conducted a cross-sectional study in 18 patients with DMD, aged 11 to 22 years. 

They found that of the 18 patients, 12 had ejection fractions lower than 52%, which defines LV systolic dysfunction according to Simpson’s method. Eight of the patients also had segmental abnormalities involving the inferolateral wall.

A total of 16 patients had a global longitudinal strain of less than 20%, which again defines LV systolic dysfunction according to Simpson. In 4 patients, the global longitudinal strain was reduced even though ejection fraction was preserved. A progressive reduction in both parameters was observed with older age.

Global longitudinal strain is an analysis of myocardial deformation, which reflects the function of subendocardial longitudinally oriented fibers that are most prone to ischemic damage. The analysis is emerging as a promising tool to predict cardiovascular outcomes.

Reference

Souza F, Cantisano A, Pereira D, et al. Assessment of left ventricular systolic dysfunction in Duchenne muscular dystrophy using conventional and subclinical measures. Poster presented at: 2022 Muscular Dystrophy Association Clinical & Scientific Conference; March 13-16, 2022; Nashville, TN. Virtual Poster.