Quantitative assessment of left ventricular longitudinal function and myocardial deformation in Duchenne muscular dystrophy patients

Abstract

Background Duchenne muscular dystrophy (DMD) manifests in males mainly by skeletal muscle impairment, but also by cardiac dysfunction. The assessment of the early phases of cardiac involvement using echocardiography is often very difficult to perform in these patients. The aim of the study was to use cardiac magnetic resonance (CMR) strain analysis and mitral annular plane systolic excursion (MAPSE) in the detection of early left ventricular (LV) dysfunction in DMD patients. Methods and results In total, 51 male DMD patients and 18 matched controls were examined by CMR. MAPSE measurement and functional analysis using feature tracking (FT) were performed. Three groups of patients were evaluated: A/ patients with LGE and LV EF < 50% (n = 8), B/ patients with LGE and LVEF ≥ 50% (n = 13), and C/ patients without LGE and LVEF ≥ 50% (n = 30). MAPSE and global LV strains of the 3 DMD groups were compared to controls (n = 18). Groups A and B had significantly reduced values of MAPSE, global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) in comparison to controls (p < 0.05). The values of MAPSE (11.6 ± 1.9 v 13.7 ± 2.7 mm) and GCS (− 26.2 ± 4.2 v − 30.0 ± 5.1%) were significantly reduced in group C compared to the controls (p < 0.05). Conclusion DMD patients had decreased LV systolic function measured by MAPSE and global LV strain even in the case of normal LV EF and the absence of LGE. FT and MAPSE measurement provide sensitive assessment of early cardiac involvement in DMD patients.

Left atrium phasic impairments in paroxysmal atrial fibrillation patients assessed by cardiovascular magnetic resonance feature tracking

“…Similarly, for LV strain assessment [global longitudinal strain (GLS), global circumferential strain (GCS) and global radial strain (GRS)], the same readers used long-axis (two-chamber, three-chamber, four-chamber) and short-axis (basal, mid-ventricular, apical) cine images. They followed a similar process as previously reported 25 .…”

Diagnostic Value of Echocardiography Combined with Serum h-FABP and cTnI in Myocardial Infarction and Its Evaluation Value in Left Ventricular Function

“…Patients with AMI are usually accompanied by heart failure in which ventricular filling or ejection is impaired due to structural or functional abnormalities of the heart. Accurate assessment of cardiac function is of great significance for the treatment and prognosis of patients with myocardial infarction [ 3 , 4 ]. There are currently many clinical methods for assessing cardiac function, including echocardiography, serological markers, and cardiac function classification by the New York Heart Association (NYHA), among which the NYHA cardiac function classification is widely used in clinical practice yet lacks quantitative indicators [ 5 , 6 ].…”

The alteration of left ventricular strain in later-onset spinal muscular atrophy children

“…In this study, we adopted the technique of 2D-STE strain imaging to detect potential cardiac impairment in children with SMA by conducting a case-control study and reached a result similar to Panovský et al (2021) study, wherein GLS was significantly decreased in patients compared with that in controls, while no significant difference was found in LVEF of patients and controls. LV strain findings further described its capacity for the accurate determination of regional myocardial motion and can be used for an early warning of potential myocardial injury.…”

“…GLS, a key indicator of LV strain, is widely used in the study of various diseases that may be complicated by subclinical cardiac impairment, such as hypertension ( Tadic and Cuspidi, 2021a ), heart transplantation ( Godown et al, 2018 ), and type 2 diabetes ( Tadic and Cuspidi, 2021b ). Panovský et al (2021) conducted a case-control study in children with DMD using cardiac magnetic resonance strain analysis for the detection of early LV dysfunction, and a decreased global LV strain was observed, even in the case of a normal LVEF, providing evidence for the use of LV strain in neuromuscular disease. The presence of cardiac manifestations in children with SMA has been reported in several clinical studies ( Wijngaarde et al, 2017 ), and great importance has been attached to severe SMA type 0 and 1 patients with cardiac structural abnormalities from an early stage of the disease ( Wijngaarde et al, 2017 ).…”

“…In addition, the global longitudinal strain (GLS) could be the best parameter for evaluating strain, which is more sensitive than LV ejection fraction (LVEF) for measuring systolic function, and may be applied to identify subclinical LV dysfunction in cardiomyopathies ( Potter and Marwick, 2018 ). For instance, assessments of the early phases of cardiac involvement in Duchenne muscular dystrophy (DMD) patients revealed significantly reduced values of GLS in the patients’ group in the case of a normal LVEF ( Amedro et al, 2019 ; Panovský et al, 2021 ). Similarly, we hypothesized that altered LV strain imaging values, as indicative of regional myocardial abnormalities, may be used to provide an early warning of myocardial injury in children with SMA; however, its applicability in the population of children with SMA is still worth investigating.…”