Document Detail


Cardiac and skeletal muscle involvement in myotonic dystrophy type 2 (DM2): a quantitative 31P-MRS and MRI study.
MedLine Citation:
PMID:  15452841     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In myotonic dystrophy type 2 (DM2/PROMM), cardiac muscle involvement is usually more benign than in DM1, but clinically severe cardiomyopathy has been reported in some patients. Using a novel method of magnetic resonance spectroscopy (MRS), we examined the left ventricular myocardium and the left gastrocnemius muscle in 11 unselected DM2/PROMM patients without overt cardiac disease. Data on cardiac morphology and function were obtained by gradient echo two-dimensional cine magnetic resonance imaging (MRI); no significant differences were found between DM2 patients and healthy controls, but using a median split approach older patients showed mildly increased left ventricular (LV) volumes, i.e., 59% increase of end-systolic volume index (ESVI) and 35% increase of end-diastolic volume index (EDVI), and an increase of LV mass (26%). On cardiac MRS, DM2/PROMM patients showed a reduction of phosphocreatine (PCr) and adenosine triphosphate (ATP) by 25 and 20% compared to matched healthy controls. No significant differences were found between younger and older patients. In skeletal muscle of the DM2 patients, no significant decrease of PCr and ATP concentrations was found. However, in older patients, who commonly show overt hip flexor muscle weakness, we observed reduced values for PCr and ATP. Our MRS and MRI findings reveal evidence for subclinical cardiomyopathy in DM2/PROMM patients without overt heart disease. Future prospective studies are needed to clarify the risk of developing overt cardiac disease in DM2 and to define prognostic factors.
Authors:
Christiane Schneider-Gold; Meinrad Beer; Herbert Köstler; Stefan Buchner; Jörn Sandstede; Dietbert Hahn; Klaus V Toyka
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Muscle & nerve     Volume:  30     ISSN:  0148-639X     ISO Abbreviation:  Muscle Nerve     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-10-25     Completed Date:  2004-12-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7803146     Medline TA:  Muscle Nerve     Country:  United States    
Other Details:
Languages:  eng     Pagination:  636-44     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Würzburg, Josef-Schneider Strasse 11, 97080 Würzburg, Germany. christiane.schneider-gold@mail.uni-wuerzburg.de <christiane.schneider-gold@mail.uni-wuerzburg.de>
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Female
Humans
Magnetic Resonance Imaging / methods,  statistics & numerical data
Magnetic Resonance Spectroscopy / methods,  standards
Male
Middle Aged
Muscle, Skeletal* / metabolism,  pathology
Myocardium* / metabolism,  pathology
Myotonic Dystrophy / classification*,  metabolism,  physiopathology*
Phosphorus Isotopes / metabolism
Protons
Statistics, Nonparametric
Chemical
Reg. No./Substance:
0/Phosphorus Isotopes; 0/Protons

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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