Silva Marly Conceição, Meira Zilda Maria Alves, Gurgel Giannetti Juliana, da Silva Marcelo Moreira, Campos Alysson Félix Oliveira, Barbosa Márcia de Melo, Starling Filho Geraldo Moll, Ferreira Rogério de Aguiar, Zatz Mayana, Rochitte Carlos Eduardo
Axial Centro de Imagem, Belo Horizonte, Minas Gerais, Brazil.
J Am Coll Cardiol. 2007 May 8;49(18):1874-9. doi: 10.1016/j.jacc.2006.10.078. Epub 2007 Apr 23.
This study sought to analyze whether cardiovascular magnetic resonance (CMR) can detect and quantify myocardial damage in the early stages of cardiomyopathy in muscular dystrophies (MD).
Muscular dystrophy is a genetic disease that involves skeletal and cardiac tissues of humans. Cardiomyopathy is common, and death secondary to cardiac or respiratory diseases occurs early in life. Cardiovascular magnetic resonance is a reliable method for assessing global and regional cardiac function, allowing also for the detection of myocardial fibrosis (MF).
Ten patients with Duchenne or Becker dystrophies were studied by CMR. Physical examination, Chagas disease serological tests, electrocardiogram, chest radiograph, total creatine kinase, and Doppler echocardiogram were also obtained in all patients.
Patients with MF had a lower ejection fraction than those without. Myocardial fibrosis (midwall and/or subepicardial) was observed in 7 of the 10 patients, and the lateral wall was the most commonly involved segment. There was moderate correlation between segmental MF and dysfunction.
Cardiovascular magnetic resonance can identify MF and may be useful for detecting the early stages of cardiomyopathy in MD. Future work will be needed to evaluate whether CMR can influence cardiomyopathy and outcomes.
本研究旨在分析心血管磁共振成像(CMR)能否检测和量化肌营养不良症(MD)患者心肌病早期的心肌损伤。
肌营养不良症是一种累及人类骨骼和心脏组织的遗传性疾病。心肌病很常见,且心脏或呼吸系统疾病导致的死亡在生命早期就会发生。心血管磁共振成像是评估整体和局部心脏功能的可靠方法,还能检测心肌纤维化(MF)。
对10例杜氏或贝克肌营养不良症患者进行了CMR检查。所有患者还进行了体格检查、查加斯病血清学检测、心电图、胸部X光片、总肌酸激酶检测以及多普勒超声心动图检查。
有MF的患者射血分数低于无MF的患者。10例患者中有7例观察到心肌纤维化(中层心肌和/或心外膜下),侧壁是最常受累的节段。节段性MF与功能障碍之间存在中度相关性。
心血管磁共振成像能够识别MF,可能有助于检测MD患者心肌病的早期阶段。未来需要开展进一步研究,以评估CMR是否会影响心肌病及其预后。