Effects of prednisolone treatment on cardiac functions in patients with Duchenne type muscular dystrophy

Duchenne muscular dystrophy is an inherited myopathy characterized by progressive skeletal muscle weakness leading to loss of ambulation, respiratory and cardiac failure.Currently, there is no cure for Duchenne muscular dystrophy. The benefits of steroid therapy have been advocated for more than 30 years. Although corticosteroids are a clinically effective pharmacologic therapy for skeletal muscle function, there is limited published data documenting the impact on cardiac functions.Objective: This prospective study was performed to detect benefit from prednisolone treatment on cardiac functions in patients with Duchenne muscular dystrophy between August 2006- June 2008.Materials and methods: This study consisted of 26 boys with Duchenne muscular dystrophy in the patient group and 19 healthy boys in control group. All patients with Duchenne muscular dystrophy have taken prednisolone at least six months. Patients were examined regularly 3 to 6 month interval. To evaluate cardiac functions all patients underwent 12-lead electrocardiography, holter monitorization, and two dimensional echocardiography, Doppler echocardiography, and tissue Doppler echocardiography. Two dimensional echocardiography, Doppler echocardiography, tissue Doppler echocardiography performed to the control group. Left atrial dimension, left ventricular end-diastolic and end-systolic dimensions, left ventricular posterior wall thickness, interventicular septal thickness at end-diastol, and left ventricular ejection fraction and fractional shortening were measured by two-dimensional echocardiography. By Doppler echocardiography mitral inflow velocities (Mitral E, Mitral A), Mitral E/Mitral A ratio, and time intervals were measured. Tissue Doppler velocities septal and lateral portions of the mitral annulus were measured by tissue Doppler echocardiography.Results: The results compared with the normal values and control group and there was no impairment at systolic functions (Left ventricular ejection fraction and fractional shortening, tissue Doppler velocities) and diastolic functions (Mitral inflow velocities and tissue Doppler velocities).Conclusion: Although, normal cardiac functions of patients? were probably due to young age, steroid therapy may have some protective effects on cardiac functions. The steroid treatment seems to be preventive for development of ventricular dysfunction but the long term studies necessitate at this topic.Key Words: Cardiac functions, muscular dystrophy, steroid treatment.