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Physical activity and cardiac function in patients with Duchenne muscular dystrophy

Mary Killian1, Jaclyn Tamaroff2, Karry Su1

  • 1Division of Pediatric Cardiology, Vanderbilt University Medical Center, Nashville, TN, USA.

Cardiology in the Young
|February 27, 2025
PubMed

Insights

Physical activity in Duchenne muscular dystrophy patients correlates with heart function, specifically left ventricular ejection fraction and cardiac index. Activity levels impact cardiac health, with ambulation status modifying this relationship.

Area of Science:

  • Cardiology
  • Neuromuscular Disorders
  • Exercise Physiology

Background:

  • Cardiomyopathy is a primary cause of mortality in Duchenne muscular dystrophy (DMD).
  • The interplay between skeletal muscle activity and cardiac function in DMD is not well understood.
  • This study investigates the link between physical activity and cardiomyopathy progression in DMD patients.

Purpose of the Study:

  • To evaluate the correlation between physical activity levels and cardiac function in individuals with Duchenne muscular dystrophy.
  • To determine if skeletal muscle activity is directly related to the development or progression of cardiomyopathy.
  • To explore how ambulation status influences the relationship between physical activity and cardiac metrics.

Main Methods:

  • Physical activity was quantified using accelerometers over a 7-day period, reporting average activity and time spent in different intensities.
  • Cardiac function was assessed via Cardiac Magnetic Resonance Imaging (CMR), measuring left ventricular ejection fraction (LVEF), global circumferential strain (Ecc), and cardiac index.
  • Spearman correlation analysis was employed to examine associations between physical activity parameters and cardiac variables.

Main Results:

  • Significant positive correlations were observed between physical activity measures and both LVEF (rho = 0.38, p = 0.01) and cardiac index (rho = 0.51, p < 0.001).
  • Lower physical activity levels were associated with reduced LVEF (p = 0.10) and cardiac index (p < 0.01).
  • The association between physical activity and LVEF was stronger in non-ambulatory patients (rho = 0.40, p = 0.03), while the association with cardiac index was stronger in ambulatory patients (rho = 0.53, p = 0.03). Global circumferential strain did not correlate with physical activity.

Conclusions:

  • Physical activity is significantly correlated with key indicators of cardiac function, LVEF and cardiac index, in DMD patients.
  • The relationship between physical activity and cardiac health is influenced by the patient's ability to ambulate.
  • Further research is warranted to elucidate the temporal dynamics between physical activity and cardiomyopathy development in Duchenne muscular dystrophy.
Abstract

Keywords:
Duchenne muscular dystrophyaccelerometrycardiomyopathy

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