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无症状的杜氏肌营养不良基因突变女性携带者的心肌固有 T 映射和细胞外容积定量。

Myocardial native T mapping and extracellular volume quantification in asymptomatic female carriers of Duchenne muscular dystrophy gene mutations.

机构信息

International Clinical Research Centre, St. Anne's University Hospital, Brno, Czech Republic.

1st Department of Internal Medicine-Cardioangiology, St. Anne's University Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic.

出版信息

Orphanet J Rare Dis. 2023 Sep 11;18(1):283. doi: 10.1186/s13023-023-02899-9.

Abstract

BACKGROUND

Female carriers of dystrophin gene mutations (DMD-FC) were previously considered non-manifesting, but in recent decades, cardiomyopathy associated with muscular dystrophy and myocardial fibrosis has been described. Our study aimed to assess prospectively myocardial fibrosis in asymptomatic DMD-FC compared to a sex-matched control group (CG) with similar age distribution using native T mapping and extracellular volume (ECV) quantification by cardiovascular magnetic resonance (CMR) imaging.

MATERIALS AND METHODS

38 DMD-FC with verified genetic mutation and 22 healthy volunteers were included. Using CMR, native T relaxation time and ECV quantification were determined in each group. Late gadolinium enhancement (LGE) was assessed in all cases.

RESULTS

There were 38 DMD-FC (mean age 39.1 ± 8.8 years) and 22 healthy volunteers (mean age 39.9 ± 12.6 years) imagined by CMR. The mean global native T relaxation time was similar for DMD-FC and CG (1005.1 ± 26.3 ms vs. 1003.5 ± 25.0 ms; p-value = 0.81). Likewise, the mean global ECV value was also similar between the groups (27.92 ± 2.02% vs. 27.10 ± 2.89%; p-value = 0.20). The segmental analysis of mean ECV values according to the American Heart Association classification did not show any differences between DMD-FC and CG. There was a non-significant trend towards higher mean ECV values of DMD-FC in the inferior and inferolateral segments of the myocardium (p-value = 0.075 and 0.070 respectively).

CONCLUSION

There were no statistically significant differences in the mean global and segmental native T relaxation times and the mean global or segmental ECV values. There was a trend towards higher segmental mean ECV values of DMD-FC in the inferior and inferolateral walls of the myocardium.

摘要

背景

肌营养不良蛋白基因突变的女性携带者(DMD-FC)以前被认为是非表现型的,但在最近几十年,与肌肉营养不良相关的心肌病和心肌纤维化已被描述。我们的研究旨在使用心血管磁共振(CMR)成像的原生 T 映射和细胞外体积(ECV)定量,前瞻性地评估无症状 DMD-FC 与具有相似年龄分布的性别匹配对照组(CG)的心肌纤维化。

材料和方法

38 名经基因验证突变的 DMD-FC 和 22 名健康志愿者被纳入研究。在每组中,使用 CMR 确定原生 T 弛豫时间和 ECV 定量。在所有病例中评估晚期钆增强(LGE)。

结果

38 名 DMD-FC(平均年龄 39.1±8.8 岁)和 22 名健康志愿者(平均年龄 39.9±12.6 岁)接受了 CMR 成像。DMD-FC 和 CG 的平均整体原生 T 弛豫时间相似(1005.1±26.3 ms 与 1003.5±25.0 ms;p 值=0.81)。同样,两组的平均整体 ECV 值也相似(27.92±2.02%与 27.10±2.89%;p 值=0.20)。根据美国心脏协会分类的平均 ECV 值的节段分析显示,DMD-FC 和 CG 之间没有差异。DMD-FC 的下壁和下侧壁心肌的平均 ECV 值有升高的非显著趋势(p 值分别为 0.075 和 0.070)。

结论

平均整体和节段性原生 T 弛豫时间以及平均整体或节段性 ECV 值没有统计学差异。DMD-FC 的下壁和下侧壁心肌节段性平均 ECV 值有升高的趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f275/10496385/28d56018bf4f/13023_2023_2899_Fig1_HTML.jpg

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