Myocardial strain changes in Duchenne muscular dystrophy without overt cardiomyopathy

Ogata, Hitoko; Nakatani, Satoshi; Ishikawa, Yoshihiro; Negishi, Akifumi; Kobayashi, Michiko; Ishikawa, Yoshimoto; Minami, Ryoji

doi:10.1016/j.ijcard.2006.02.013

Cited by 45 publications

(47 citation statements)

References 22 publications

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“…In the posterior wall, six of the DMD patients had postsystolic shortening in the inner-half; four of the DMD patients had systolic thinning in the outer-half of the posterior wall. These data of the current study was concordant with previous pathological and MRI studies [6,7] and tissue Doppler strain imaging studies [15,16].…”

Section: Discussionsupporting

confidence: 93%

“…Therefore, the Doppler derived strain measurement cannot reliably measure the radial strain in the anterior and inferior walls. Using the tissue Doppler strain imaging Ogata et al also reported, some DMD patients with normal LV function showed systolic thinning in the outer layer of the posterolateral wall [16]. In the current study, the strain analysis using the two-dimensional speckle tracking method is not limited by any angle dependency.…”

Section: Discussionmentioning

confidence: 59%

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Segmental Myocardial Strain of the Left Ventricle in Patients With Duchenne Muscular Dystrophy Using Two-Dimensional Speckle Tracking Echocardiography

et al. 2008

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Background. Myocardial fibrosis occurs in the subepicardial myocardium of the left ventricular posterior wall in patients with Duchenne Muscular Dystrophy (DMD). The aim of this study was to clarify how these regional myocardial lesions might influence the focal cardiac movement using two-dimensional speckle tracking echocardiography and to investigate whether this new method is useful for the early detection of cardiac involvement in DMD patients. Methods and Results.Twelve DMD patients with a normal fractional shortening (FS) of the left ventricle and twelve healthy age-matched control subjects were enrolled in this study. The segmental radial strain of the left ventricle was recorded using the two-dimensional tissue tracking echocardiography, and the systolic maximal strain was measured.Thereafter, the peak systolic maximal strain was separately measured in the inner-half and outer-half of the left ventricular posterior wall. In DMD patients, the systolic maximal radial strain of the septum, posterior, and inferior walls were significantly lower than those in normal subjects. In particular, the systolic maximal radial strain of the posterior wall in the DMD patients was the most significantly decreased (P<0.0001). Six of the DMD patients had postsystolic shortening in the inner-half, and four of the DMD patients had systolic thinning in the outer-half of the posterior wall. Conclusions.Even if the FS is normal, the left ventricular posterior wall of DMD patients often showed an abnormal strain pattern. A segmental myocardial strain analysis might be useful for the early detection of cardiac involvement in DMD patients. (J Echocardiogr 2008; 4: 100-108)

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 59%

Segmental Myocardial Strain of the Left Ventricle in Patients With Duchenne Muscular Dystrophy Using Two-Dimensional Speckle Tracking Echocardiography

et al. 2008

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“…Additionally, myocardial strain imaging has demonstrated impairment of radial systolic thickening in the posterolateral segment of the left ventricle. Strain profiles more commonly were abnormal in the outer layer of the myocardium than the inner layer in keeping with epimyocardial involvement seen on pathologic examination [16]. Reductions in systolic deformation as well as reduced early diastolic myocardial velocities also have been demonstrated in the inferolateral and anterolateral segments [17].…”

Section: Imagingmentioning

confidence: 60%

Cardiac Assessment in Duchenne and Becker Muscular Dystrophies

Romfh

McNally

2010

Curr Heart Fail Rep

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Mutations in the dystrophin gene cause Duchenne and Becker muscular dystrophies. In addition to muscle disease, there nearly always is an associated cardiomyopathy in Duchenne or Becker muscular dystrophy. In these muscular dystrophies, the severity of cardiomyopathy and congestive heart failure may not parallel the severity of skeletal muscle disease. Loss of normal dystrophin function in the heart produces four-chamber dilation and reduction in left ventricular function that develop after the onset of muscle weakness. Arrhythmias affecting both atrial and ventricular rhythms occur and may be life threatening. The degree to which hypoventilation and pulmonary dysfunction are present also directly affect cardiac function in muscular dystrophy. Care guidelines recently were issued to outline surveillance and treatment strategies for the younger patient with Duchenne muscular dystrophy. Herein, we review those guidelines, and additionally, provide recommendations for monitoring and treating cardiac disease in the populations of advanced Duchenne and Becker muscular dystrophies.

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“…A recent study has shown its potential for detecting abnormal strain profiles in patients. 35 Also by using a phase-tracking method, it is possible to measure thickening in two layers in the fetal heart. 36 The 4 layer measurements in this epicardial experimental study is beyond clinical use.…”

Section: Clinical Applicationsmentioning

confidence: 99%

Multilayer radial systolic strain can identify subendocardial ischemia: An experimental tissue Doppler imaging study of the porcine left ventricular wall

Matre

Moen

Fanneløp

et al. 2007

European Journal of Echocardiography

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Aims: This study investigates whether subendocardial ischemia can be detected by measuring multilayer radial systolic strain from epicardial tissue Doppler imaging. Methods:In 10 anesthetized open-chest pigs an extracorporeal shunt from the proximal brachiocephalic to the left anterior descending coronary artery was constricted in steps. Color microsphere injections and short axis Tissue Velocity Imaging (TVI) recordings were performed with open shunt, with a non-significant stenosis, and with 2 steps of shunt flow reduction.Results: With open shunt and no transmural flow gradient, there was a gradient of peak ejection strain with high values subendocardially for both 4 and 2 layer measurements. For 2 layer measurement strain was 56.0 AE 10.5% subendocardially and 22.0 AE 5.2% subepicardially. A non-significant stenosis, not altering transmural flow distribution, reduced strain to 40.3 AE 5.4% in the endocardial half-layer. With reduced shunt flow resulting in subendocardial ischemia, peak ejection strain decreased further, primarily in inner wall layers, and postsystolic strain became evident. At severe stenosis (52.4 AE 1.8% shunt flow reduction) strain was reduced to 3.8 AE 3.6% in the subendocardium and 0.0 AE 2.6% in the subepicardium. Conclusion: Evaluation of myocardial function with multilayer radial systolic strain has a potential for detecting subendocardial ischemia.

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Myocardial strain changes in Duchenne muscular dystrophy without overt cardiomyopathy

Cited by 45 publications

References 22 publications

Segmental Myocardial Strain of the Left Ventricle in Patients With Duchenne Muscular Dystrophy Using Two-Dimensional Speckle Tracking Echocardiography

Segmental Myocardial Strain of the Left Ventricle in Patients With Duchenne Muscular Dystrophy Using Two-Dimensional Speckle Tracking Echocardiography

Cardiac Assessment in Duchenne and Becker Muscular Dystrophies

Multilayer radial systolic strain can identify subendocardial ischemia: An experimental tissue Doppler imaging study of the porcine left ventricular wall

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