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Comparison of left ventricular function assessment between echocardiography and MRI in Duchenne muscular dystrophy

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Abstract

Background

Cardiomyopathy in Duchenne muscular dystrophy (DMD) is associated with death in approximately 40% of patients. Echocardiography is routinely used to assess left ventricular (LV) function; however, it has limitations in these patients.

Objective

We compared echocardiographic measures of cardiac function assessment to cardiac MRI.

Materials and methods

We included children and young adults with DMD who had MRI performed between January 2010 and July 2015. We measured echocardiographic and MRI parameters of function assessment, including strain. Presence of late gadolinium enhancement (LGE) was assessed by MRI. Subjects were divided into two groups based on MRI left ventricular ejection fraction (LVEF): group I, LVEF ≥55% and group II, LVEF <55%.

Results

We included 41 studies in 33 subjects, with 25 in group I and 16 in group II. Mean age of subjects was 13.6 ± 2.8 years and mean duration between echocardiogram and MRI was 7.6 ± 4.1 months. Only 8 of 16 (50%) patients in group II had diminished function on echocardiogram. Echocardiographic images were suboptimal in 16 subjects (39%). Overall, echocardiographic parameters had weak correlation with MRI-derived ejection fraction percentage. MRI-derived myocardial strain assessment has better correlation with MRI ejection fraction as compared to echocardiography-derived strain parameters.

Conclusion

Echocardiography-based ventricular functional assessment has weak correlation with MRI parameters in children and young adults with Duchenne muscular dystrophy. While this correlation improves in the subset of subjects with adequate echocardiographic image quality, it remains modest and potentially suboptimal for clinical management. Accordingly, we conclude that MRI should be performed routinely and early in children with DMD, not only for LGE imaging but also for functional assessment.

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Authors and Affiliations

  1. Division of Cardiology, Department of Pediatrics, University of Washington School of Medicine and Seattle Children’s Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA

    Sujatha Buddhe, Mark Lewin, Aaron Olson & Brian D. Soriano

  2. Department of Radiology, University of Washington School of Medicine and Seattle Children’s Hospital, Seattle, WA, USA

    Mark Ferguson

Authors
  1. Sujatha Buddhe
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  2. Mark Lewin
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  3. Aaron Olson
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  4. Mark Ferguson
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  5. Brian D. Soriano
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Correspondence to Sujatha Buddhe.

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Buddhe, S., Lewin, M., Olson, A. et al. Comparison of left ventricular function assessment between echocardiography and MRI in Duchenne muscular dystrophy. Pediatr Radiol 46, 1399–1408 (2016). https://doi.org/10.1007/s00247-016-3622-y

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  • DOI: https://doi.org/10.1007/s00247-016-3622-y

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