Assessment of Left Ventricular Functions With Strain and Strain Rate Echocardiography in Children with Duchenne Muscular Dystrophy

Year 2020, Volume: 27 Issue: 1, 59 - 66, 01.03.2020

Mahmut Keskin , Özben Ceylan , Senem Özgür Utku Arman Örün Vehbi Doğan Osman Yılmaz , Filiz Şenocak Selmin Karademir

https://doi.org/10.17343/sdutfd.554940

Abstract

Özet

Amaç: Çalışmamızda konvansiyonel ekokardiyografi ile kalp fonksiyonları
normal bulunan Duchenne Musküler Distrofili (DMD) hastaların miyokard
fonksiyonlarının  pulse wave doku doppler
görüntüleme (PWDDG) ve strain/strain rate (S/SR) ekokardiyografi aracılığıyla  ölçülmesi ve kontrol grubu ile
karşılaştırılması amaçlandı.

Materyal ve Metod: Bu çalışmada;
ortalama yaşı 85,2 ± 38,4 ay olan 32 DMD’li erkek hasta ve 89 ± 38,9 ay olan 31
sağlıklı çocuk değerlendirildi. Demografik özellikler olgular ve kontrol
grubunda değerlendirildi. Cinsiyet, yaş, vücut kitle indeksi, konvansiyonel  ekokardiyografi verileri, pulse wave doku Doppler
görüntüleme (PW-TDI) verileri ve iki boyutlu (2D) longitudinal strain (LS) / longitudinal
strain rate (LSR) ekokardiyografi değerleri karşılaştırıldı.

Bulgular: Hasta ve kontrol grupları arasında kalp hızı bakımından istatistiksel
olarak anlamlı fark saptandı (p<0.001) ve DMD’li grupta kalp hızı daha
yüksekti. Ventriküler septumda bazal ölçümlerinde Em, S amplitüdü, izovolümetrik relaksasyon zamanı (İVRZ), miyokard
performans indeksi (MPİ) bakımından istatistiksel yönden anlamlı fark saptanırken
(p<0,05), sol ventrikü serbest duvar bazalindeki ölçümlerde de Em, S amplitüdü ve İVRZ bakımından istatistiksel yönden anlamlı fark
bulundu (p<0,05). Sol ventrikülün serbest duvar bazalindeki strain ve strain
rate değerlerinde DMD’ligrup ve kontrol grubu arasında istatistiki yönden  anlamlı fark saptandı (p<0.001). Yapılan apikal
dört boşluk pozisyondaki global strain değerlerinde DMD’li grup ve kontrol
grubu arasında istatistiki yönden anlamlı fark saptandı ( p<0,001).

 Sonuç: Transtorasik ekokardiyografide normal aralık içinde sol
ventrikül sistolik fonksiyon saptanan DMD'li asemptomatik hastalarda kontrol
grubu ile karşılaştırıldığında sol ventrikül anterolateral duvarında LS ve LSR
değerleri anlamlı olarak düşük bulundu.

Anahtar
kelimeler: Longitudinal
strain, longitudinal strain rate, Duchenne musküler distrofi

Abstract

Aim:
The goal of our study was to detect the left ventricular functions of duchenne muscular
dystrophy (DMD)
patients using, pulsed-wave
tissue Doppler imaging (PW-TDI, longitudinal strain (LS) and longitudinal
strain rate (LSR)
echocardiography who had normal left ventricular functions in standart
echocardiography before, and to match them with the results of the control
group.

Material and Methods:
İn this study compared 32
boys with DMD whose mean age was 85.2 ± 38.4 months were matched with 31
healthy males whose mean age was 89.0 ± 38.9 months. The following demographic features were assesed in
both DMD patients  and controls: gender,
age, body mass index, standard echocardiography parameters, pulsed-wave tissue
Doppler imaging (PW-TDI) findings, and two-dimensional (2D) LS/LSR
echocardiography measurements.

Results:
Asymptomatic boys with DMD were established to have high heart rate
(p<0.001). In the calculations performed from the base of the ventricular
septum, statistically considerable differences were determined   between the Em, S amplitude and isovolumetric
relaxation time (IVRT), myocard performance index (MPI) values of the two
groups (p<0.05). In the evaluates made from the base of the left ventricular
free wall, Em, S amplitude and IVRT, MPI values were demonstrated to be more considerably
different (p<0.05). The results of the LS and LSR measurements done from the
base of the left ventricular free wall were considerably different between DMD and
control group (p<0.001), and in the global strain measurement performed from
the four chamber apical position, considerable distinction was noted between
the two groups (p<0.001).

Conclusion: In patients with DMD in whom standart
echocardiography had assesed left ventricular systolic function within the
normal range showed significantly lower LS and LSR values at the left
ventricular anterolateral wall compared with the control group.

Keywords: Longitudinal strain, longitudinal strain rate,
duchenne muscular dystrophy, 

Keywords

Longitudinal strain, longitudinal strain rate, duchenne muscular dystrophy

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