title: Detection of long-term progression of myocardial fibrosis in Duchenne muscular dystrophy in an affected family: a cardiovascular magnetic resonance study.
abstract: BACKGROUND
  Detection of myocardial fibrosis and left ventricular dysfunction in Duchenne muscular dystrophy (DMD) is the corner stone for further therapeutic studies. Little is known about the ability of cardiac magnetic resonance imaging (CMR) to evaluate progression of myocardial fibrosis. Aim of our study was to provide CMR data in a previously genotyped DMD family and to evaluate whether progression of myocardial fibrosis could be visualized.
  
  
  RESULTS
  DMD genotypes were available in 14 family members. CMR was performed in 4/5 carrier females, in 2/2 affected males and in one healthy family member with normal genotype. Functional images and late gadolinium enhanced (LGE) images in contiguous short-axis orientation were acquired at baseline and follow-up of 1231 days CMR examination could be repeated in three carrier females, in one affected male and in the healthy subject previously scanned. Mean decrease of left ventricular ejection fraction during the follow-up period was 10.5±11.0%, mean progression of LGE volume 11.7±9.5%.
  
  
  CONCLUSIONS
  Myocardial fibrosis seems to occur prior to global left ventricular dysfunction in DMD diseased males and carrier females. CMR could be used to evaluate progression of myocardial fibrosis and left ventricular function and may thus serve as an important diagnostic tool in the evaluation of therapeutical options in DMD.
authors.affiliation: Department of Internal Medicine II, University of Ulm, Ulm, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Walcher
authors.forename: Peter
authors.initials: P
authors.lastname: Steinbach
authors.forename: Jochen
authors.initials: J
authors.lastname: Spiess
authors.forename: Markus
authors.initials: M
authors.lastname: Kunze
authors.forename: Robert
authors.initials: R
authors.lastname: Gradinger
authors.forename: Daniel
authors.initials: D
authors.lastname: Walcher
authors.forename: Peter
authors.initials: P
authors.lastname: Bernhardt
mesh_terms: D000328:Adult; D009202:Cardiomyopathies / Q000150:complications / Q000175:diagnosis* / Q000235:genetics; D018450:Disease Progression; D005260:Female; D005355:Fibrosis; D006579:Heterozygote; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020388:Muscular Dystrophy, Duchenne / Q000150:complications / Q000235:genetics*; D009206:Myocardium / Q000473:pathology*; D010375:Pedigree; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis* / Q000235:genetics; D055815:Young Adult