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Erschienen in: Pediatric Cardiology 5/2016

02.03.2016 | Original Article

Relationship of Right Ventricular Size and Function with Respiratory Status in Duchenne Muscular Dystrophy

verfasst von: Muddassir Mehmood, Stephanie A. Ambach, Michael D. Taylor, John L. Jefferies, Subha V. Raman, Robin J. Taylor, Hemant Sawani, Jacob Mathew, Wojciech Mazur, Kan N. Hor, Hussein R. Al-Khalidi

Erschienen in: Pediatric Cardiology | Ausgabe 5/2016

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Abstract

The relationship between pulmonary function and right ventricle (RV) in Duchenne muscular dystrophy (DMD) has not been evaluated. Using cardiac magnetic resonance (CMR), we describe the relationship of RV size and function with spirometry in a DMD cohort. Fifty-seven boys undergoing CMR and pulmonary function testing within 1 month at a single center (2013–2015) were enrolled. Comparisons of RV ejection fraction (RVEF) and end-diastolic volume index (RVEDVI) were made across categories of percent forced vital capacity (FVC%), and relationships were assessed. Mean age was 15.5 ± 3.5 years. Spirometry and CMR were performed within 3.9 ± 4.1 days. Median FVC% was 92.0 % (67.5–116.5 %). Twenty-three (40 %) patients had abnormal FVC% (<80 %) of which 13 (57 %) had mild (FVC% 60–79 %), 6 (26 %) had moderate (FVC% 40–59 %), and 4 (17 %) had severe (FVC <40 %) reductions. Mean RVEF was 58.3 ± 3.7 %. Patients with abnormal FVC% were older and had lower RVEF and RVEDVI. Both RVEF and RVEDVI were significantly associated with FVC% (r = 0.31, p = 0.02 and r = 0.39, p = 0.003, respectively). In a large DMD cohort, RVEF and RVEDVI were related to FVC%. Worsening respiratory status may guide monitoring of cardiac function in these patients.
Literatur
1.
Zurück zum Zitat Baydur A, Gilgoff I, Prentice W, Carlson M, Fischer DA (1990) Decline in respiratory function and experience with long term assisted ventilation in advanced Duchenne’s muscular dystrophy. Chest 97:884–889CrossRefPubMed Baydur A, Gilgoff I, Prentice W, Carlson M, Fischer DA (1990) Decline in respiratory function and experience with long term assisted ventilation in advanced Duchenne’s muscular dystrophy. Chest 97:884–889CrossRefPubMed
2.
Zurück zum Zitat Birnkrant DJ, Bushby KM, Amin RS, Bach JR, Benditt JO, Eagle M, Finder JD, Kalra MS, Kissel JT, Koumbourlis AC, Kravitz RM (2010) The respiratory management of patients with Duchenne muscular dystrophy: a DMD care considerations working group specialty article. Pediatr Pulmonol 45(8):739–748CrossRefPubMed Birnkrant DJ, Bushby KM, Amin RS, Bach JR, Benditt JO, Eagle M, Finder JD, Kalra MS, Kissel JT, Koumbourlis AC, Kravitz RM (2010) The respiratory management of patients with Duchenne muscular dystrophy: a DMD care considerations working group specialty article. Pediatr Pulmonol 45(8):739–748CrossRefPubMed
3.
Zurück zum Zitat Bushby K, Muntoni F, Urtizberea A, Hughes R, Griggs R (2004) Report on the 124th ENMC international workshop. In: Treatment of Duchenne muscular dystrophy; defining the gold standards of management in the use of corticosteroids. 2–4 April, Naarden, The Netherlands. Neuromuscul Disord 14(8–9):526–534 Bushby K, Muntoni F, Urtizberea A, Hughes R, Griggs R (2004) Report on the 124th ENMC international workshop. In: Treatment of Duchenne muscular dystrophy; defining the gold standards of management in the use of corticosteroids. 2–4 April, Naarden, The Netherlands. Neuromuscul Disord 14(8–9):526–534
4.
Zurück zum Zitat Eagle M, Baudouin SV, Chandler C, Giddings DR, Bullock R, Bushby K (2002) Survival in Duchenne muscular dystrophy: improvements in life expectancy since 1967 and the impact of home nocturnal ventilation. Neuromuscul Disord 12:926–929CrossRefPubMed Eagle M, Baudouin SV, Chandler C, Giddings DR, Bullock R, Bushby K (2002) Survival in Duchenne muscular dystrophy: improvements in life expectancy since 1967 and the impact of home nocturnal ventilation. Neuromuscul Disord 12:926–929CrossRefPubMed
5.
Zurück zum Zitat Emery AE (1991) Population frequencies of inherited neuromuscular diseases–a world survey. Neuromuscul Disord 1(1):19–29CrossRefPubMed Emery AE (1991) Population frequencies of inherited neuromuscular diseases–a world survey. Neuromuscul Disord 1(1):19–29CrossRefPubMed
6.
Zurück zum Zitat Hapke EJ, Meek JC, Jacobs J (1972) Pulmonary function in progressive muscular dystrophy. Chest 61(1):41–47CrossRefPubMed Hapke EJ, Meek JC, Jacobs J (1972) Pulmonary function in progressive muscular dystrophy. Chest 61(1):41–47CrossRefPubMed
7.
Zurück zum Zitat Hilde JM, Skjørten I, Grøtta OJ, Hansteen V, Melsom MN, Hisdal J, Humerfelt S, Steine K (2013) Right ventricular dysfunction and remodeling in chronic obstructive pulmonary disease without pulmonary hypertension. J Am Coll Cardiol 62(12):1103–1111CrossRefPubMed Hilde JM, Skjørten I, Grøtta OJ, Hansteen V, Melsom MN, Hisdal J, Humerfelt S, Steine K (2013) Right ventricular dysfunction and remodeling in chronic obstructive pulmonary disease without pulmonary hypertension. J Am Coll Cardiol 62(12):1103–1111CrossRefPubMed
8.
Zurück zum Zitat Kawut SM, Poor HD, Parikh MA, Hueper K, Smith BM, Bluemke DA, Lima JA, Prince MR, Hoffman EA, Austin JH, Vogel-Claussen J, Barr RG (2014) Cor pulmonale parvus in chronic obstructive pulmonary disease and emphysema: the MESA COPD study. J Am Coll Cardiol 64(19):2000–2009CrossRefPubMedPubMedCentral Kawut SM, Poor HD, Parikh MA, Hueper K, Smith BM, Bluemke DA, Lima JA, Prince MR, Hoffman EA, Austin JH, Vogel-Claussen J, Barr RG (2014) Cor pulmonale parvus in chronic obstructive pulmonary disease and emphysema: the MESA COPD study. J Am Coll Cardiol 64(19):2000–2009CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Magalang UJ, Richards K, McCarthy B, Fathala A, Khan M, Parinandi N, Raman SV (2009) Continuous positive airway pressure therapy reduces right ventricular volume in patients with obstructive sleep apnea: a cardiovascular magnetic resonance study. J Clin Sleep Med 5(2):110–114PubMedPubMedCentral Magalang UJ, Richards K, McCarthy B, Fathala A, Khan M, Parinandi N, Raman SV (2009) Continuous positive airway pressure therapy reduces right ventricular volume in patients with obstructive sleep apnea: a cardiovascular magnetic resonance study. J Clin Sleep Med 5(2):110–114PubMedPubMedCentral
11.
Zurück zum Zitat Markham LW, Spicer RL, Cripe LH (2005) The heart in muscular dystrophy. Pediatr Ann 34(7):531–535CrossRefPubMed Markham LW, Spicer RL, Cripe LH (2005) The heart in muscular dystrophy. Pediatr Ann 34(7):531–535CrossRefPubMed
12.
Zurück zum Zitat Mayer OH, Finkel RS, Rummey C, Benton MJ, Glanzman AM, Flickinger J, Lindström BM, Meier T (2015) Characterization of pulmonary function in Duchenne Muscular Dystrophy. Pediatr Pulmonol 50(5):487–494CrossRefPubMedPubMedCentral Mayer OH, Finkel RS, Rummey C, Benton MJ, Glanzman AM, Flickinger J, Lindström BM, Meier T (2015) Characterization of pulmonary function in Duchenne Muscular Dystrophy. Pediatr Pulmonol 50(5):487–494CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Piña IL, Apstein CS, Balady GJ, Belardinelli R, Chaitman BR, Duscha BD, Fletcher BJ, Fleg JL, Myers JN, Sullivan MJ (2003) American Heart Association Committee on exercise, rehabilitation, and prevention. Exercise and heart failure: a statement from the American Heart Association Committee on exercise, rehabilitation, and prevention. Circulation 107(8):1210–1225CrossRefPubMed Piña IL, Apstein CS, Balady GJ, Belardinelli R, Chaitman BR, Duscha BD, Fletcher BJ, Fleg JL, Myers JN, Sullivan MJ (2003) American Heart Association Committee on exercise, rehabilitation, and prevention. Exercise and heart failure: a statement from the American Heart Association Committee on exercise, rehabilitation, and prevention. Circulation 107(8):1210–1225CrossRefPubMed
14.
Zurück zum Zitat Rideau Y, Gatin G, Bach J, Gines G (1983) Prolongation of life in Duchenne’s muscular dystrophy. Acta Neurol 5:118–124 Rideau Y, Gatin G, Bach J, Gines G (1983) Prolongation of life in Duchenne’s muscular dystrophy. Acta Neurol 5:118–124
15.
Zurück zum Zitat Schram G, Fournier A, Leduc H, Dahdah N, Therien J, Vanasse M, Khairy P (2013) All-cause mortality and cardiovascular outcomes with prophylactic steroid therapy in Duchenne muscular dystrophy. J Am Coll Cardiol 61(9):948–954CrossRefPubMed Schram G, Fournier A, Leduc H, Dahdah N, Therien J, Vanasse M, Khairy P (2013) All-cause mortality and cardiovascular outcomes with prophylactic steroid therapy in Duchenne muscular dystrophy. J Am Coll Cardiol 61(9):948–954CrossRefPubMed
16.
Zurück zum Zitat Shivkumar K, Ravi K, Henry JW, Eichenhorn M, Stein PD (1994) Right ventricular dilatation, right ventricular wall thickening, and Doppler evidence of pulmonary hypertension in patients with a pure restrictive ventilatory impairment. Chest 106(6):1649–1653CrossRefPubMed Shivkumar K, Ravi K, Henry JW, Eichenhorn M, Stein PD (1994) Right ventricular dilatation, right ventricular wall thickening, and Doppler evidence of pulmonary hypertension in patients with a pure restrictive ventilatory impairment. Chest 106(6):1649–1653CrossRefPubMed
17.
Zurück zum Zitat Simonds AK (2002) Respiratory complications of the muscular dystrophies. Semin Respir Crit Care Med 23(3):231–238CrossRefPubMed Simonds AK (2002) Respiratory complications of the muscular dystrophies. Semin Respir Crit Care Med 23(3):231–238CrossRefPubMed
18.
Zurück zum Zitat van de Veerdonk MC, Marcus JT, Bogaard HJ, Vonk Noordegraaf A (2014) State of the art: advanced imaging of the right ventricle and pulmonary circulation in humans (2013 Grover Conference series). Pulm Circ 4(2):158–168CrossRefPubMedPubMedCentral van de Veerdonk MC, Marcus JT, Bogaard HJ, Vonk Noordegraaf A (2014) State of the art: advanced imaging of the right ventricle and pulmonary circulation in humans (2013 Grover Conference series). Pulm Circ 4(2):158–168CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat van der Geest RJ, Reiber JH (1999) Quantification in cardiac MRI. J Magn Reson Imaging 10(5):602–608CrossRefPubMed van der Geest RJ, Reiber JH (1999) Quantification in cardiac MRI. J Magn Reson Imaging 10(5):602–608CrossRefPubMed
20.
Zurück zum Zitat van der Geest RJ, Buller VG, Jansen E, Lamb HJ, Baur LH, van der Wall EE, de Roos A, Reiber JH (1997) Comparison between manual and semiautomated analysis of left ventricular volume parameters from short-axis MR images. J Comput Assist Tomogr 21(5):756–765CrossRefPubMed van der Geest RJ, Buller VG, Jansen E, Lamb HJ, Baur LH, van der Wall EE, de Roos A, Reiber JH (1997) Comparison between manual and semiautomated analysis of left ventricular volume parameters from short-axis MR images. J Comput Assist Tomogr 21(5):756–765CrossRefPubMed
21.
Zurück zum Zitat Wang X, Dockery DW, Wypij D et al (1993) Pulmonary function between 6 and 18 years of age. Pediatr Pulmonol 15:75–88CrossRefPubMed Wang X, Dockery DW, Wypij D et al (1993) Pulmonary function between 6 and 18 years of age. Pediatr Pulmonol 15:75–88CrossRefPubMed
Metadaten
Titel
Relationship of Right Ventricular Size and Function with Respiratory Status in Duchenne Muscular Dystrophy
verfasst von
Muddassir Mehmood
Stephanie A. Ambach
Michael D. Taylor
John L. Jefferies
Subha V. Raman
Robin J. Taylor
Hemant Sawani
Jacob Mathew
Wojciech Mazur
Kan N. Hor
Hussein R. Al-Khalidi
Publikationsdatum
02.03.2016
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 5/2016
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-016-1362-2

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