Current understanding and management of dilated cardiomyopathy in Duchenne and Becker muscular dystrophy.
OBJECTIVE
To review the current understanding of the pathophysiology of dilated cardiomyopathy (DCM) in patients with Duchenne and Becker muscular dystrophies, assessment of cardiac dysfunction for these patients, and the recommended pharmacological treatment options and ongoing research directions.


METHODS
Reviews and original research articles from scholarly journals and books.


CONCLUSIONS
Duchenne and Becker muscular dystrophies are debilitating neuromuscular disorders, both caused by mutations in the dystrophin gene. Most patients develop DCM as part of the disease course; in fact, DCM is the leading cause of death among these patients. Cardiac surveillance, including routine monitoring of electrocardiograms, echocardiograms, and appropriate blood biomarkers, may detect early DCM development. Although previous studies have shown that early administration of cardiac medications may delay the development of DCM, current standard of care does not emphasize cardiac surveillance and timely treatment. This, in turn, limits clinicians, including advanced practice nurses, to be optimally engaged in providing the most aggressive and proactive patient care.


CONCLUSIONS
Implementing a routine cardiac assessment and timely pharmacological treatment in primary or specialty care settings is highlighted as an important step to optimize cardiac health among patients with Duchenne and Becker muscular dystrophies.
The Ohio State University College of Nursing, Columbus, Ohio, USA.
Rita Wen
RW
Kaspar
Hugh D
HD
Allen
Federica
F
Montanaro
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics / Q000517:prevention & control*; D002423:Cause of Death; D018450:Disease Progression; D016189:Dystrophin / Q000235:genetics; D042241:Early Diagnosis; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D020388:Muscular Dystrophy, Duchenne / Q000150:complications / Q000235:genetics; D009154:Mutation / Q000235:genetics; D009722:Nurse Practitioners; D024802:Nurse's Role; D009730:Nursing Assessment; D010641:Phenotype; D017410:Practice Guidelines as Topic; D011320:Primary Health Care
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D016189:Dystrophin