CARDIOLOGY IN THE YOUNG, 2026 (SCI-Expanded, Scopus)
Aim: Cardiac complications significantly contribute to mortality in Duchenne muscular dystrophy patients. Early detection of cardiac involvement is crucial for optimising therapeutic interventions. This study aimed to evaluate the role of N-terminal pro-brain natriuretic peptide in detecting cardiac involvement, as assessed by real-time three-dimensional (four-dimensional) and three-dimensional speckle-tracking echocardiography in patients with Duchenne muscular dystrophy. Material and methods: This cross-sectional study enrolled individuals under 21 years. Participants underwent clinical evaluation, real-time three-dimensional echocardiography, three-dimensional speckle-tracking echocardiography, and simultaneous measurement of serum N-terminal pro-brain natriuretic peptide levels. Correlation analysis between echocardiographic parameters and N-terminal pro-brain natriuretic peptide was performed. Results: The study comprised 38 Duchenne muscular dystrophy patients with a mean age of 9.40 +/- 4.13 years. Moderate significant correlations were observed between N-terminal pro-brain natriuretic peptide and echocardiographic parameters, including basal anterolateral and inferolateral longitudinal strain, apical septal longitudinal strain, and basal anterolateral and inferolateral radial strain (p < 0.05). Subgroup analysis based on N-terminal pro-brain natriuretic peptide (<125 pg/ml vs. >= 125 pg/ml) revealed impaired basal anterolateral longitudinal strain in patients with high N-terminal pro-brain natriuretic peptide. Conclusion: This is the first study that includes N-terminal pro-brain natriuretic peptide in conjunction with real-time three-dimensional echocardiography and three-dimensional speckle-tracking echocardiography for assessing cardiac involvement in Duchenne muscular dystrophy patients. The observed correlations between N-terminal pro-brain natriuretic peptide levels and regional contraction parameters hold promise for its relevance as a biomarker for cardiac dysfunction. Prospective studies with a larger population with a broader range of disease severity are necessary in patients with Duchenne muscular dystrophy.