Korean J Pediatr.  2018 Feb;61(2):59-63. 10.3345/kjp.2018.61.2.59.

Cardiac function associated with home ventilator care in Duchenne muscular dystrophy

• Lee S
• Lee H
• Eun LY
• Gang SW

• KMID: 2452042
• DOI: http://doi.org/10.3345/kjp.2018.61.2.59

Abstract

PURPOSE
Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups.
METHODS
We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital. Demographic characteristics, pulmonary function, and echocardiography data were investigated.
RESULTS
Fifty-four patients with Duchenne muscular dystrophy were divided into 2 groups: home ventilator-assisted and non-ventilator-assisted. The patients in the home ventilator group were older (16.25±1.85 years) than those in the nonventilator group (14.73±1.36 years) (P=0.001). Height, weight, and body surface area did not differ significantly between groups. The home ventilator group had a lower seated functional vital capacity (1,038±620.41 mL) than the nonventilator group (1,455±603.12 mL). Mean left ventricular ejection fraction and fractional shortening were greater in the home ventilator group, but the data did not show any statistical difference. The early ventricular filling velocity/late ventricular filling velocity ratio (1.7±0.44) was lower in the home ventilator group than in the nonventilator group (2.02±0.62). The mitral valve annular systolic velocity was higher in the home ventilator group (estimated β, 1.06; standard error, 0.48). Patients with Duchenne muscular dystrophy on a ventilator may have better systolic and diastolic cardiac functions.
CONCLUSION
Noninvasive ventilator assistance can help preserve cardiac function. Therefore, early utilization of noninvasive ventilation or oxygen may positively influence cardiac function in patients with Duchenne muscular dystrophy.

Keyword

Cardiac function test; Mechanical ventilators; Duchenne muscular dystrophy

MeSH Terms

Body Surface Area
Cardiomyopathies
Cause of Death
Cough
Echocardiography
Heart Function Tests
Humans
Lung
Mitral Valve
Muscular Dystrophy, Duchenne*
Noninvasive Ventilation
Oxygen
Retrospective Studies
Stroke Volume
Ventilation
Ventilators, Mechanical*
Vital Capacity
Oxygen