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Use of advanced heart failure therapies in Duchenne muscular dystrophy
- Source :
- Prog Pediatr Cardiol
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Background As survival and neuromuscular function in Duchenne Muscular Dystrophy (DMD) improve with glucocorticoid therapy and respiratory advances, the proportion of cardiac deaths is increasing. Little is known about the use and outcomes of advanced heart failure (HF) therapies in this population. Methods A retrospective cohort study of 436 males with DMD was performed, from January 1, 2005-January 1, 2018, with the primary outcome being use of advanced HF therapies including: implantable cardioverter defibrillator (ICD), left ventricular assist device (LVAD), and heart transplantation (HTX). Results Nine subjects had an ICD placed, 2 of whom (22.2%) had appropriate shocks for ventricular tachycardia; 1 and 968 days after implant, and all of whom were alive at last follow-up; median 18 (IQR: 12.5–25.5) months from implant. Four subjects had a LVAD implanted with post-LVAD survival of 75% at 1 year; 2 remaining on support and 1 undergoing HTX. One subject was bridged to HTX with ICD and LVAD and was alive at last follow-up, 53 months after HTX. Conclusion Advanced HF therapies may be used effectively in select subjects with DMD. Further studies are needed to better understand risk stratification for ICD use and optimal candidacy for LVAD implantation and HTX, with hopes of improving cardiac outcomes.
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
medicine.medical_treatment
Duchenne muscular dystrophy
Population
030204 cardiovascular system & hematology
Ventricular tachycardia
Article
03 medical and health sciences
0302 clinical medicine
030225 pediatrics
Internal medicine
medicine
education
Heart transplantation
Transplantation
education.field_of_study
business.industry
Retrospective cohort study
medicine.disease
Implantable cardioverter-defibrillator
Heart failure
Ventricular assist device
Pediatrics, Perinatology and Child Health
Cardiology
Surgery
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 10589813
- Volume :
- 53
- Database :
- OpenAIRE
- Journal :
- Progress in Pediatric Cardiology
- Accession number :
- edsair.doi.dedup.....366ddb8a301119c559c365ca98c879f1