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R2 Predicting Scores for Left Ventricular Dysfunction in Duchenne Muscular Dystrophy.
MedLine Citation:
PMID:  22248373     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective:  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. Background:  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 which can find abnormal LV contraction, and to develop weighted scoring system. Echocardiogram was performed as the gold standard for detecting LV dysfunction. Results:  Four parameters were associated with abnormal LV contraction, (1) brain natriuretic peptide, (2) creatine kinase, (3) scoliosis and (4) body surface area. When BNP was used as the only predictor to evaluate of 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 is combined with the other three factors, raising the sensitivity of 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. © 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.
Authors:
Tetsushi Yamamoto; Seiji Kawano; Daisuke Sugiyama; Tetsuari Onishi; Nobuhide Hayashi; Yasuhiro Takeshima; Hiroya Kawai; Ken-Ichi Hirata; Masafumi Matsuo; Shunichi Kumagai
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-16
Journal Detail:
Title:  Pediatrics international : official journal of the Japan Pediatric Society     Volume:  -     ISSN:  1442-200X     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886002     Medline TA:  Pediatr Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.
Affiliation:
Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan. Department of Clinical Pathology and Immunology, Kobe University Graduate School of Medicine, Kobe, Japan. Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
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