Missing the beat: Unaddressed dimensions in the electrocardiographic evaluation of Duchenne muscular dystrophy

The recent study by Krishnamurthy et al. explores electrocardiographic (ECG) patterns in Duchenne muscular dystrophy (DMD), a timely topic in cardiomyopathy surveillance. However, the study omits crucial aspects that could enhance clinical relevance: early ECG deviations in young asymptomatic patients, genotype-informed risk stratification, integration with imaging modalities, and implications for patient monitoring protocols. We propose a multidimensional framework-age-specific, mutation-aware, and imaging-supported-for future ECG studies to better align with the goals of anticipatory cardiac care in DMD.