A current approach to heart failure in Duchenne muscular dystrophy

Domenico D'Amario, Antonio Amodeo, Rachele Adorisio, Francesco Danilo Tiziano, Antonio Maria Leone, Gianluigi Perri, Piergiorgio Bruno, Massimo Massetti, Alessandra Ferlini, Marika Pane, Giampaolo Niccoli, Italo Porto, Gianluca A. D'Angelo, Josip Anä Borovac, Eugenio Mercuri, Filippo Crea

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Duchenne muscular dystrophy (DMD) is a genetic, progressive neuromuscular condition that is marked by the long-term muscle deterioration with significant implications of pulmonary and cardiac dysfunction. As such, end-stage heart failure (HF) in DMD is increasingly becoming the main cause of death in this population. The early detection of cardiomyopathy is often challenging, due to a long subclinical phase of ventricular dysfunction and difficulties in assessment of cardiovascular symptomatology in these patients who usually loose ambulation during the early adolescence. However, an early diagnosis of cardiovascular disease in patients with DMD is decisive since it allows a timely initiation of cardioprotective therapies that can mitigate HF symptoms and delay detrimental heart muscle remodelling. Echocardiography and ECG are standardly used for screening and detection of cardiovascular abnormalities in these patients, although these tools are not always adequate to detect an early, clinically asymptomatic phases of disease progression. In this regard, cardiovascular magnetic resonance (CMR) with late gadolinium enhancement is emerging as a promising method for the detection of early cardiac involvement in patients with DMD. The early detection of cardiac dysfunction allows the therapeutic institution of various classes of drugs such as corticosteroids, beta-blockers, ACE inhibitors, antimineralocorticoid diuretics and novel pharmacological and surgical solutions in the multimodal and multidisciplinary care for this group of patients. This review will focus on these challenges and available options for HF in patients with DMD.

Original languageEnglish
Pages (from-to)1770-1779
Number of pages10
JournalHeart
Volume103
Issue number22
DOIs
Publication statusPublished - Nov 1 2017

Fingerprint

Duchenne Muscular Dystrophy
Heart Failure
Cardiovascular Abnormalities
Ventricular Dysfunction
Asymptomatic Diseases
Early Ambulation
Gadolinium
Cardiomyopathies
Angiotensin-Converting Enzyme Inhibitors
Diuretics
Echocardiography
Disease Progression
Early Diagnosis
Cause of Death
Myocardium
Patient Care
Adrenal Cortex Hormones
Electrocardiography
Cardiovascular Diseases
Magnetic Resonance Spectroscopy

Keywords

  • cardiomyopathy, dilated
  • heart failure
  • muscular dystrophy, Duchenne
  • therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

D'Amario, D., Amodeo, A., Adorisio, R., Tiziano, F. D., Leone, A. M., Perri, G., ... Crea, F. (2017). A current approach to heart failure in Duchenne muscular dystrophy. Heart, 103(22), 1770-1779. https://doi.org/10.1136/heartjnl-2017-311269

A current approach to heart failure in Duchenne muscular dystrophy. / D'Amario, Domenico; Amodeo, Antonio; Adorisio, Rachele; Tiziano, Francesco Danilo; Leone, Antonio Maria; Perri, Gianluigi; Bruno, Piergiorgio; Massetti, Massimo; Ferlini, Alessandra; Pane, Marika; Niccoli, Giampaolo; Porto, Italo; D'Angelo, Gianluca A.; Borovac, Josip Anä; Mercuri, Eugenio; Crea, Filippo.

In: Heart, Vol. 103, No. 22, 01.11.2017, p. 1770-1779.

Research output: Contribution to journalArticle

D'Amario, D, Amodeo, A, Adorisio, R, Tiziano, FD, Leone, AM, Perri, G, Bruno, P, Massetti, M, Ferlini, A, Pane, M, Niccoli, G, Porto, I, D'Angelo, GA, Borovac, JA, Mercuri, E & Crea, F 2017, 'A current approach to heart failure in Duchenne muscular dystrophy', Heart, vol. 103, no. 22, pp. 1770-1779. https://doi.org/10.1136/heartjnl-2017-311269
D'Amario, Domenico ; Amodeo, Antonio ; Adorisio, Rachele ; Tiziano, Francesco Danilo ; Leone, Antonio Maria ; Perri, Gianluigi ; Bruno, Piergiorgio ; Massetti, Massimo ; Ferlini, Alessandra ; Pane, Marika ; Niccoli, Giampaolo ; Porto, Italo ; D'Angelo, Gianluca A. ; Borovac, Josip Anä ; Mercuri, Eugenio ; Crea, Filippo. / A current approach to heart failure in Duchenne muscular dystrophy. In: Heart. 2017 ; Vol. 103, No. 22. pp. 1770-1779.
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