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Diagnostic utility of cardiac magnetic resonance for detection of cardiac involvement in female carriers of Duchenne muscular dystrophy
  1. Takashi Iwase1,
  2. Shoichiro Takao2,
  3. Masashi Akaike1,
  4. Katsuhito Adachi3,
  5. Yuka Sumitomo-Ueda4,
  6. Shusuke Yagi1,
  7. Toshiyuki Niki1,
  8. Kenya Kusunose1,
  9. Noriko Tomita1,
  10. Yoichiro Hirata1,
  11. Koji Yamaguchi1,
  12. Kunihiko Koshiba1,
  13. Yoshio Taketani1,
  14. Hirotsugu Yamada1,
  15. Takeshi Soeki1,
  16. Tetsuzo Wakatsuki1,
  17. Ken-ichi Aihara4,
  18. Masafumi Harada2,
  19. Hiromu Nishitani5,
  20. Masataka Sata1
  1. 1Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
  2. 2Department of Medical Imaging, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
  3. 3Department of Internal Medicine and Neurology, Tokushima National Hospital, Tokushima, Japan
  4. 4Department of Medicine and Bioregulatory Sciences, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
  5. 5Department of Radiology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
  1. Correspondence to Dr Takashi Iwase, Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan; tiwase{at}clin.med.tokushima-u.ac.jp

Abstract

Background Cardiac involvement is a recognised complication in female carriers of Duchenne muscular dystrophy (DMD). Since segmental or global left ventricle (LV) wall motion abnormalities in DMD carriers can arise even without apparent muscle weakness, it is difficult to differentiate cardiac involvement of a DMD carrier from other heart diseases in a non-invasive manner. Cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE) enables assessment of regional wall motion abnormality and myocardial damage with high spatial resolution.

Objective To assess the utility of CMR for detection of myocardial damage in female carriers of DMD.

Methods and results Gadolinium-enhanced CMR was performed in seven female DMD carriers. Physical examination, electrocardiography, chest radiograph, measurements of total creatinine kinase and brain natriuretic peptide levels, and two-dimensional echocardiography were also performed. Four (57%) of the seven carriers had LGE, and LGE was frequently observed at the subepicardial layer in the inferolateral segment. Two carriers had a focal LGE at the LV inferolateral wall without LV dilation or wall motion abnormalities.

Conclusion CMR findings of DMD carriers were characterised by subepicardial LGE, which was localised at inferolateral segments. CMR may be a useful modality for detecting cardiac involvement in DMD carriers.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Ethics Committee of The University of Tokushima Graduate School.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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