Cardiomyopathy in a patient with Duchenne dystrophy

Authors: Reznik E.V.1 2, Khachirova E.А.1 2, Iarovoi M.D.1, Golukhov G.N.2

Company: 1 Pirogov Russian National Research Medical University, Moscow, Russian Federation
2 City Clinical Hospital № 31 named after G.M. Savelieva, Moscow, Russian Federation

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Type:  Case reports


DOI: https://doi.org/10.24022/1997-3187-2025-19-2-241-248

For citation: Reznik E.V., Khachirova E.А., Iarovoi M.D., Golukhov G.N. Cardiomyopathy in a patient with Duchenne dystrophy. Creative Cardiology. 2025; 19 (2): 241–248 (in Russ.). DOI: 10.24022/1997-3187-2025-19-2-241-248

Received / Accepted:  17.03.2025 / 27.03.2025

Keywords: Duchenne dystrophy cardiomyopathy creatine phosphokinase dystrophin



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Abstract

Progressive Duchenne muscular dystrophy is a genetic disease with an incidence rate of 1:5000 in males. It occurs as a result of a mutation in the Duchenne muscular dystrophy gene, responsible for the synthesis of the dystrophin protein, which is most often localized in skeletal muscles and myocardium. Cardiological manifestations of this disease include progressive hypertrophic and dilated cardiomyopathy, as well as various arrhythmias that can lead to death. Echocardiography and electrocardiography are used as diagnostic methods for cardiac manifestations of progressive Duchenne muscular dystrophy; fewer sensitive methods include determining the level of creatine phosphokinase, troponin I and other laboratory parameters. Our work describes a clinical case of a patient with a confirmed diagnosis of progressive Duchenne dystrophy and diagnosed cardiomyopathy at the age of 15 years. The disease is progressive in nature with an unfavorable prognosis.

References

  1. Clinical guidelines of the Ministry of Health of the Russian Federation. Progressive Duchenne muscular dystrophy. Becker’s progressive muscular dystrophy, 2023. https://dmd-russia.ru/wp-content/uploads/2023/12/klinicheskie_rekomendatsii.pdf (Accessed 12.02.2025)
  2. Petrof B.J., Shrager J.B., Stedman H.H., Kelly A.M., Sweeney H.L. Dystrophin protects the sarcolemma from stresses developed during muscle contraction. Proc. Natl. Acad. Sci. USA. 1993; 90 (8): 3710–3714. DOI: 10.1073/pnas.90.8.3710
  3. Wallace G.Q., McNally E.M. Mechanisms of muscle degeneration, regeneration, and repair in the muscular dystrophies. Annu Rev. Physiol. 2009; 71: 37–57. DOI: 10.1146/annurev.physiol.010908.163216
  4. Kamdar F., Garry D.J. Dystrophin-deficient cardiomyopathy. J. Am. Coll. Cardiol. 2016; 67: 2533–2546.
  5. Aartsma-Rus A., Van Deutekom J.C., Fokkema I.F., Van Ommen G.J., Den Dunnen J.T. Entries in the Leiden Duchenne muscular dystrophy mutation database: an overview of mutation types and paradoxical cases that confirm the reading-frame rule. Muscle Nerve. 2006; 34 (2): 135–144. DOI: 10.1002/mus.20586
  6. Magri F., Govoni A., D’Angelo M.G., Del Bo R., Ghezzi S., Sandra G. et al. Genotype and phenotype characterization in a large dystrophinopathic cohort with extended follow-up. J. Neurol. 2011; 258 (9): 1610–1623. DOI: 10.1007/s00415-011-5979-z
  7. Gaynetdinova D.D., Novoselova A.A. Current diagnosis and treatment of Duchenne muscular dystrophy. Kazan Medical Journal. 2020; 101 (4): 530–537 (in Russ.). DOI: 10.17816/KMJ2020-530
  8. Groznova O.S., Rudenskaya G.E., Adyan T.A., Kharlamov D.A. Cardiac lesion in children with inherited neuromuscular diseases. Russian Bulletin of Perinatology and Pediatrics. 2014; 59 (2): 35–42 (in Russ.).
  9. Ervasti J.M., Ohlendieck K., Kahl S.D., Gaver M.G., Campbell K.P. Deficiency of a glycoprotein component of the dystrophin complex in dystrophic muscle. Nature. 1990; 345 (6273): 315–319. DOI: 10.1038/345315a0
  10. Franco A. Jr, Lansman J.B. Calcium entry through stretch-inactivated ion channels in mdx myotubes. Nature. 1990; 344 (6267): 670–673. DOI: 10.1038/344670a0
  11. Gandhi S., Sweeney H.L., Hart C.C., Han R., Perry C.G.R. Cardiomyopathy in Duchenne muscular dystrophy and the potential for mitochondrial therapeutics to improve treatment response. Cells. 2024; 13 (14): 1168. DOI: 10.3390/cells13141168
  12. Spurney C.F., Ascheim D., Charnas L., Cripe L., Hor K., King N. et al. Current state of cardiac troponin testing in Duchenne muscular dystrophy cardiomyopathy: review and recommendations from the Parent Project Muscular Dystrophy expert panel. Open Heart. 2021; 8 (1): e001592. DOI: 10.1136/openhrt-2021-001592
  13. Yanagisawa A., Yokota N., Miyagawa M., Kawamura J., Ishihara T., Aoyagi T., Ishikawa K. Plasma levels of atrial natriuretic peptide in patients with Duchenne’s progressive muscular dystrophy. Am. Heart J. 1990; 120 (5): 1154–1158. DOI: 10.1016/0002-8703(90)90130-p
  14. Spurney C., Shimizu R., Morgenroth L.P., Kolski H., Gordish-Dressman H., Clemens P.R.; CINRG Investigators. Cooperative International Neuromuscular Research Group Duchenne Natural History Study demonstrates insufficient diagnosis and treatment of cardiomyopathy in Duchenne muscular dystrophy. Muscle Nerve. 2014; 50 (2): 250–256. DOI: 10.1002/mus.24163
  15. Giatrakos N., Kinali M., Stephens D., Dawson D., Muntoni F., Nihoyannopoulos P. Cardiac tissue velocities and strain rate in the early detection of myocardial dysfunction of asymptomatic boys with Duchenne’s muscular dystrophy: relationship to clinical outcome. >Heart. 2006; 92 (6): 840–842. DOI:
  16. Tang L., Shao S., Wang C. Electrocardiographic features of children with Duchenne muscular dystrophy. Orphanet. J. Rare Dis. 2022; 17: 320. DOI: 10.1186/s13023-022-02473-9
  17. Zhou J., Wang Ch. Electrocardiographic features of children with Duchenne muscular dystrophy and genotype analysis. J. Precis. Med. 2018; 33 (04): 300–303.
  18. Shah A.M., Jefferies J.L., Rossano J.W., Decker J.A., Cannon B.C., Kim J.J. Electrocardiographic abnormalities and arrhythmias are strongly associated with the development of cardiomyopathy in muscular dystrophy. Heart Rhythm. 2010; 7 (10): 1484–1488. DOI: 10.1016/j.hrthm.2010.06.022
  19. Connuck D.M., Sleeper L.A., Colan S.D., Cox G.F., Towbin J.A., Lowe A.M. et al. Characteristics and outcomes of cardiomyopathy in children with Duchenne or Becker muscular dystrophy: a comparative study from the Pediatric Cardiomyopathy Registry. Am. Heart J. 2008; 155: 998–1005.
  20. Rose E.A., Gelijns A.C., Moskowitz A.J., Heitjan D.F., Stevenson L.W., Dembitsky W. et al. Long-term use of a left ventricular assist device. N. Engl. J. Med. 2001; 345: 1435–1443.
  21. Dubinin M.V., Starinets V.S., Chelyadnikova Y.A., Belosludtseva N.V., Mikheeva I.B., Penkina D.K. et al. Effect of large-conductance calcium-dependent K+ channel activator NS1619 on function of mitochondria in the heart of dystrophin-deficient mice. Biochemistry (Mosc.). 2023; 88 (2): 189–201. DOI: 10.1134/S0006297923020037
  22. Nigro G., Comi L.I., Limongelli F.M., Giugliano M.A., Politano L., Petretta V. et al. Prospective study of X-linked progressive muscular dystrophy in Campania. Muscle Nerve. 1983; 6 (4): 253–262. DOI: 10.1002/mus.880060403
  23. Boeva O.I., Shcheglova E.V., Bulgakova N.E., Yagoda A.V. A case of dilated cardiomyopathy in a patient with a hereditary disease – progressive Duchenne–Becker muscular dystrophy. Medical Bulletin of the North Caucasus. 2013; 8 (1): 104–108 (in Russ.).
  24. Greiner E., Ikeda N., Ryan T.D., Villa C.R. Hypertrophic cardiomyopathy in Duchenne muscular dystrophy: a case series. Cardiol. Young. 2024; 34 (10): 2272–2274. DOI: 10.1017/S1047951124026659

About Authors

  • Elena V. Reznik, Dr. Med. Sci., Associate Professor, Head of the Department of Internal Disease Propedeutics № 2, Terapevt, Cardiologist, Functional Diagnostician, Physician of Ultrasonic Diagnostics, Clinical Pharmacologist; ORCID
  • Elvira A. Khachirova, Cand. Med. Sci., Associate Professor; ORCID
  • Maksim D. Iarovoi, Student; ORCID
  • Georgy N. Golukhov, Dr. Med. Sci., Corresponding Member of the Russian Academy of Sciences; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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