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Electrocardiographic prediction of late gadolinium enhancement on cardiac magnetic resonance in Becker muscular dystrophy
- Source :
- Neuromuscular Disorders. 32:43-49
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Dystrophin deficiency results in cardiomyopathy and fibrosis with variable onset. Little is known about electrocardiographic abnormalities in Becker muscular dystrophy and their relationship to underlying cardiac pathology. We hypothesized QRS fragmentation is associated with myocardial fibrosis on cardiac magnetic resonance imaging in Becker muscular dystrophy patients. We retrospectively evaluated 44 patients, and extracted data from clinically obtained electrocardiogram and cardiac magnetic resonance. Ventricular function and presence or absence late gadolinium enhancement representing myocardial fibrosis were recorded from imaging. Nearly half (19/42, 45%) of patients interrogated had myocardial fibrosis on cardiac magnetic resonance. Total number of electrocardiogram leads with QRS fragmentation (median 1 vs 4, p 0.001) and either right or left axis deviation from median was significantly increased (13.6 vs. 44.8°, p 0.001) in patients with myocardial fibrosis. Decreased leftward voltage in V6 correlated to both increased fibrosis and decreased cardiac function (p 0.01). The positive likelihood ratio for underlying myocardial fibrosis in patients with two of the three findings on electrocardiogram was 8.47 (p 0.0001). QRS fragmentation and axis deviation on electrocardiography are strongly predictive of myocardial fibrosis in Becker muscular dystrophy and may inform the use of advanced imaging in evaluation of these patients.
- Subjects :
- Adult
Male
musculoskeletal diseases
medicine.medical_specialty
Adolescent
Cardiomyopathy
Contrast Media
Magnetic Resonance Imaging, Cine
Gadolinium
Ventricular Function, Left
Electrocardiography
Young Adult
Fibrosis
Cardiac magnetic resonance imaging
Internal medicine
medicine
Humans
Late gadolinium enhancement
cardiovascular diseases
Muscular dystrophy
Child
Genetics (clinical)
Retrospective Studies
medicine.diagnostic_test
biology
business.industry
medicine.disease
Magnetic Resonance Imaging
Muscular Dystrophy, Duchenne
Neurology
Pediatrics, Perinatology and Child Health
cardiovascular system
Cardiology
biology.protein
Myocardial fibrosis
Neurology (clinical)
Cardiomyopathies
business
Cardiac magnetic resonance
Dystrophin
Subjects
Details
- ISSN :
- 09608966
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Neuromuscular Disorders
- Accession number :
- edsair.doi.dedup.....085465871837fe26472e869b3c2d7b30