[Diameter decrement of abdominal aorta and redistribution of systemic blood flow in non-ambulant Duchenne muscular dystrophy patients].
Cardiomyopathy is a major life-threatening complication in Duchenne muscular dystrophy (DMD). Cardiac output is always low in advanced stage patients. Impaired muscles presumably require extremely low circulation, while blood flow to brain and internal organs is probably maintained. Therefore, the redistribution of systemic circulation must be another important factor which determines whether or not the cardiomyopathy results in fatal heart failure. Although great efforts have been focused on the cardiac function, this problem has seldom attracted attentions. Assuming that diameter of blood vessels reflects blood flow, we measured the diameter of abdominal aorta on CT at four levels: 1) beginning of the abdominal aorta, 2) before and 3) after the branching of renal arteries, 4) before bifurcation of the common iliac arteries. Six bed-ridden DMD patients were compared with 10 ambulant patients suffering from other neurological and non-neurological diseases. We obtained following results. First, the diameter of abdominal aorta is significantly smaller in DMD patients. Second, the decrement is most prominent between before and after the branching of the renal arteries. These results clearly showed predilection of renointestinal circulation at the sacrifice of lower extremities. This narrowing of distal aorta was also observed in Kugelberg-Welander disease and understood as a sequelae of longstanding abolition of lower extremity functions.
Shinoe
T
T
Department of Neurology and Rehabilitation Medicine, Shimoshizu National Hospital.
Kawai
M
M
D000328:Adult; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D001775:Blood Circulation; D002648:Child; D006801:Humans; D008875:Middle Aged; D009043:Motor Activity; D009068:Movement; D009136:Muscular Dystrophies / Q000473:pathology / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed