Asymmetric Myocardial Involvement as an Early Indicator of Cardiac Dysfunction in Pediatric Dystrophinopathies: A Study on Cardiac Magnetic Resonance (CMR) Parametric Mappings
Por:
Esmel-Vilomara, R, Riaza, L, Costa-Comellas, L, Sabaté-Rotes, A, Gran, F
Publicada:
1 mar 2025
Ahead of Print:
1 abr 2024
Resumen:
Dystrophinopathies, such as Duchenne and Becker muscular dystrophy, frequently lead to cardiomyopathy, being its primary cause of mortality. Detecting cardiac dysfunction early is crucial, but current imaging methods lack insight into microstructural remodeling. This study aims to assess the potential of cardiac magnetic resonance (CMR) parametric mappings for early detection of myocardial involvement in dystrophinopathies and explores whether distinct involvement patterns may indicate impending dysfunction. In this prospective study, 23 dystrophinopathy patients underwent CMR with tissue mappings. To establish a basis for comparison, a control group of 173 subjects was analyzed. CMR protocols included SSFP, T2-weighted and T1-weighted sequences pre and post gadolinium, and tissue mappings for native T1 (nT1), extracellular volume (ECV), and T2 relaxation times. The difference between the left ventricular posterior wall and the interventricular septum was calculated to reveal asymmetric myocardial involvement. Significant differences in LV ejection fraction (LVEF), myocardial mass, and late gadolinium enhancement confirmed abnormalities in patients. Tissue mappings: nT1 (p < 0.001) and ECV (p = 0.002), but not T2, displayed substantial variations, suggesting sensitivity to myocardial involvement. Asymmetric myocardial involvement in nT1 (p = 0.01) and ECV (p = 0.012) between septal and LV posterior wall regions was significant. While higher mapping values didn't correlate with dysfunction, asymmetric involvement in nT1 (rho=-0.472, p = 0.023) and ECV (rho=-0.460, p = 0.049) exhibited a significant negative correlation with LVEF. CMR mappings show promise in early myocardial damage detection in dystrophinopathies. Although mapping values may not directly correspond to dysfunction, the negative correlation between asymmetric involvement in nT1 and ECV with LVEF suggests their potential as early biomarkers. Larger, longitudinal studies are needed for a comprehensive understanding and improved risk stratification in dystrophinopathies.
Filiaciones:
Esmel-Vilomara, R:
Univ Autonoma Barcelona, Fac Med, Barcelona, Spain
Vall dHebron Hosp Campus, Pediat Cardiol, Carrer St Quinti 89, Barcelona 08041, Spain
Hosp Santa Creu i St Pau, IIB St Pau, Pediat Cardiol, Barcelona, Spain
Riaza, L:
Univ Autonoma Barcelona, Fac Med, Barcelona, Spain
Vall dHebron Hosp Campus, Pediat Radiol, Barcelona, Spain
Costa-Comellas, L:
Univ Autonoma Barcelona, Fac Med, Barcelona, Spain
Vall dHebron Hosp Campus, Pediat Neurol, Barcelona, Spain
Sabaté-Rotes, A:
Univ Autonoma Barcelona, Fac Med, Barcelona, Spain
Vall dHebron Hosp Campus, Pediat Cardiol, Carrer St Quinti 89, Barcelona 08041, Spain
Gran, F:
Univ Autonoma Barcelona, Fac Med, Barcelona, Spain
Vall dHebron Hosp Campus, Pediat Cardiol, Carrer St Quinti 89, Barcelona 08041, Spain
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