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  2. Keyword: Duchenne Muscular Dystrophy
Figure 1
IJCS
Brief Communication

Prevalence of Subclinical Left Ventricular Dysfunction Evaluated by Global Longitudinal Strain in Female Carriers of Duchenne Muscular Dystrophy

Eduarda Vieira Rodrigues et al. Antonio Pedro Lima Costa Pereira Wilson Braz Correa Filho Maria Angelica de Faria Domingues de Lima … Marcio Aloysio Freitas Siqueira Junior Ana Paula Cassetta dos Santos Nucera Fabio de Souza

Abstract

Duchenne muscular dystrophy (DMD) is a muscular disease genetically linked to the DMD gene, which encodes dystrophin, a protein that is crucial for the integrity of skeletal muscle and myocytes. This condition follows an X-linked inheritance pattern. Female carriers are typically asymptomatic; however, they may develop cardiomyopathy, making screening for structural heart disease advisable. We conducted a cross-sectional study to assess the prevalence of subclinical left ventricular (LV) dysfunction, defined by reduced global longitudinal strain (GLS), in asymptomatic female DMD carriers. Participants underwent 2-dimensional speckle tracking echocardiography following a standardized protocol, with GLS values ≤ 18% classified as reduced. Continuous variables were described as mean ± standard deviation and categorical variables as percentages. The association between left ventricular ejection fraction (LVEF) and GLS was assessed using Pearson’s correlation coefficient. The significance level adopted was 5%. Using a convenience sample, 17 participants (mean age 39 ± 5 years) were enrolled. No significant changes were observed in LV diameters, and the mean LVEF was 62% ± 5%. Reduced GLS was identified in 3 participants, indicating a prevalence of 17.6% for subclinical LV dysfunction. A weak correlation was found between GLS and LVEF (r = 0.366). Our findings indicate that approximately 1 in 6 female DMD carriers had subclinical LV dysfunction. These results highlight the need for genetic counseling for mothers of patients with DMD, as well as early screening with sensitive methods to detect heart disease in female DMD carriers.

  • Duchenne Muscular Dystrophy
  • Global Longitudinal Strain
  • Left Ventricular Dysfunction
  • Women's Health
  • X-Linked Genetic Diseases
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Creative Commons Attribution (CC BY) Creative Commons license
24/03/2025 DOI: 10.36660/ijcs.20230125
Electrocardiographic and Autonomic Nervous System Changes after Changes in the Posture of Children and Adolescents with Duchenne Muscular Dystrophy
ABC
Original Article

Electrocardiographic and Autonomic Nervous System Changes after Changes in the Posture of Children and Adolescents with Duchenne Muscular Dystrophy

Rose Mary Ferreira Lisboa da Silva et al. Nathalia Mussi Monteze Juliana Gurgel Giannetti Zilda Maria Alves Meira

Abstract

Background:

Duchenne Muscular Dystrophy (DMD) is a rare inherited neuromuscular disease. At first, cardiac involvement may be asymptomatic. Therefore, assessing patients using non-invasive methods can help detect any changes.

Objectives:

Analyze the electrocardiogram (ECG) test and heart rate variability (HRV) of the DMD group and compare the information with that of the age-matched control group.

Methods:

A prospective study with 27 male patients with DMD (11.9 years old), who underwent clinical evaluation, ECG, echocardiogram, and Holter monitoring. ECG (200% increase) was assessed by two independent observers. HRV was measured over time (24 h) and in the frequency domain, in the supine and sitting positions. The healthy group consisted of nine patients (11.0 years old). A value of p < 0.05 was considered statistically significant.

Results:

The mean ejection fraction (EF) was 60% (34 to 71%). The Kappa coefficient for ECG measurements ranged from 0.64 to 1.00. An increase in the R/S ratio in V1 was observed in 25.9% of the subjects, pathological Q wave in 29.6%, and fragmented QRS in 22.2% in inferior/high lateral regions, with a negative correlation with EF (p = 0.006). There was low HRV, without the influence of any variable, including treatment. With the change in position, there was an increase in HR (p = 0.004), but there was no change in HRV. The LF/HF ratio was 2.7 in the DMD group and 0.7 in the control group (p = 0.002).

Conclusions:

In DMD subjects, prominent R waves in V1 and changes in the inferior/high lateral regions occurred in almost 30% of the cases. Lower vagal tone was observed without the influence of the variables age, ejection fraction, QT dispersion, and treatment. Despite the increase in HR, there was no adequate HRV response to the change in position.

  • Autonomic Nervous System
  • Duchenne Muscular Dystrophy
  • Electrocardiography
  • Heart Rate
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Creative Commons Attribution (CC BY) Creative Commons license
05/04/2024 DOI: 10.36660/abc.20230483 Views 1

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Rodrigues EV, Pereira APLC, Correa Filho WB, Lima MAFD, Siqueira Junior MAF, Nucera APCS, Souza F, et al. Prevalence of Subclinical Left Ventricular Dysfunction Evaluated by Global Longitudinal Strain in Female Carriers of Duchenne Muscular Dystrophy. International Journal of Cardiovascular Sciences 2025;38:e20230125.

Electronic Document Format (ABNT)

Rodrigues, Eduarda Vieira; Pereira, Antonio Pedro Lima Costa; Correa Filho, Wilson Braz; Lima, Maria Angelica de Faria Domingues de; Siqueira Junior, Marcio Aloysio Freitas; Nucera, Ana Paula Cassetta dos Santos; Souza, Fabio de. Prevalence of Subclinical Left Ventricular Dysfunction Evaluated by Global Longitudinal Strain in Female Carriers of Duchenne Muscular Dystrophy. International Journal of Cardiovascular Sciences, v. 38, e20230125, Mar. 2025.

Electronic Document Format (APA)

Rodrigues, E. V., Pereira, A. P. L. C., Correa Filho, W. B., Lima, M. A. F. D. , Siqueira Junior, M. A. F., Nucera, A. P. C. S., & Souza, F. (2025). Prevalence of Subclinical Left Ventricular Dysfunction Evaluated by Global Longitudinal Strain in Female Carriers of Duchenne Muscular Dystrophy. International Journal of Cardiovascular Sciences, 38, e20230125.

Electronic Document Format (ISO)

Rodrigues, Eduarda Vieira and Pereira, Antonio Pedro Lima Costa and Correa Filho, Wilson Braz and Lima, Maria Angelica de Faria Domingues de and Siqueira Junior, Marcio Aloysio Freitas and Nucera, Ana Paula Cassetta dos Santos and Souza, Fabio de. Prevalence of Subclinical Left Ventricular Dysfunction Evaluated by Global Longitudinal Strain in Female Carriers of Duchenne Muscular Dystrophy. International Journal of Cardiovascular Sciences [online]. 2025, vol. 38, [cited 2026-10-14], e20230125. Available from: <https://journals.cardiol.br/en/article/prevalence-of-subclinical-left-ventricular-dysfunction-evaluated-by-global-longitudinal-strain-in-female-carriers-of-duchenne-muscular-dystrophy/>. ISSN 2359-4802

EndNote RIS

Electronic Document Format (Vancouver)

Silva RMFL, Monteze NM, Giannetti JG, Meira ZMA. Electrocardiographic and Autonomic Nervous System Changes after Changes in the Posture of Children and Adolescents with Duchenne Muscular Dystrophy. Arquivos Brasileiros de Cardiologia 2024;121(2):e20230483.

Electronic Document Format (ABNT)

Silva, Rose Mary Ferreira Lisboa da; Monteze, Nathalia Mussi; Giannetti, Juliana Gurgel; Meira, Zilda Maria Alves. Electrocardiographic and Autonomic Nervous System Changes after Changes in the Posture of Children and Adolescents with Duchenne Muscular Dystrophy. Arquivos Brasileiros de Cardiologia, v. 121, n. 2, e20230483, Apr. 2024.

Electronic Document Format (APA)

Silva, R. M. F. L. , Monteze, N. M., Giannetti, J. G., & Meira, Z. M. A. (2024). Electrocardiographic and Autonomic Nervous System Changes after Changes in the Posture of Children and Adolescents with Duchenne Muscular Dystrophy. Arquivos Brasileiros de Cardiologia, 121(2), e20230483.

Electronic Document Format (ISO)

Silva, Rose Mary Ferreira Lisboa da and Monteze, Nathalia Mussi and Giannetti, Juliana Gurgel and Meira, Zilda Maria Alves. Electrocardiographic and Autonomic Nervous System Changes after Changes in the Posture of Children and Adolescents with Duchenne Muscular Dystrophy. Arquivos Brasileiros de Cardiologia [online]. 2024, vol. 121, n. 2, [cited 2026-10-14], e20230483. Available from: <https://journals.cardiol.br/en/article/electrocardiographic-and-autonomic-nervous-system-changes-after-changes-in-the-posture-of-children-and-adolescents-with-duchenne-muscular-dystrophy/>. ISSN 0066-782X

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