NDLI: Predicting scores for left ventricular dysfunction in Duchenne muscular dystrophy.

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Predicting scores for left ventricular dysfunction in Duchenne muscular dystrophy.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Yamamoto, Tetsushi Kawano, Seiji Sugiyama, Daisuke Onishi, Tetsuari Hayashi, Nobuhide Takeshima, Yasuhiro Kawai, Hiroya Hirata, Ken-ichi Matsuo, Masafumi Kumagai, Shunichi
Description	Country affiliation: Japan Author Affiliation: Yamamoto T ( Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan.)
Abstract	BACKGROUND: The aim of this study was to predict left ventricular (LV) dysfunction and the timing to perform echocardiography in patients with Duchenne muscular dystrophy (DMD). We developed a scoring system using clinical parameters and examined its efficacy. It is indispensable to utilize echocardiogram for evaluating myocardial damage of DMD patients, but there is no established guideline for determining the clinical conditions which require echocardiographic examination. METHODS: We retrospectively analyzed 86 patients with DMD who were treated in Kobe University Hospital from 2007 to 2009. The multiple logistic regression analysis on routine clinical data was performed to identify parameters that can find abnormal LV contraction, and to develop a weighted scoring system. Echocardiogram was performed as the gold standard for detecting LV dysfunction. RESULTS: Four parameters were associated with abnormal LV contraction: (i) brain natriuretic peptide (BNP); (ii) creatine kinase; (iii) scoliosis; and (iv) body surface area. When BNP was used as the only predictor to evaluate LV systolic dysfunction, sensitivity and specificity were 36.4% and 92.1%, respectively. In contrast, abnormal LV contraction was detected in high accuracy (sensitivity: 95.5%; specificity: 68.3%) when we used a two-step scoring system in which BNP was combined with the other three factors, raising the sensitivity compared to using BNP levels as the single parameter (P= 0.008). CONCLUSION: Our scoring system detects the early heart dysfunction of DMD patients, especially when BNP level is not elevated. This system is useful to determine the timing for echocardiographic examination and consulting cardiologists.
File Format	HTM / HTML
ISSN	13288067
Issue Number	3
Volume Number	54
e-ISSN	1442200X
Journal	Pediatrics International
Language	English
Publisher	Wiley
Publisher Date	2012-06-01
Publisher Place	Australia
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pediatrics Muscular Dystrophy, Duchenne Complications Ventricular Dysfunction, Left Diagnosis Etiology Adolescent Adult Child Child, Preschool Humans Prognosis Retrospective Studies Young Adult Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Pediatrics, Perinatology and Child Health

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