Evaluation of cardiac autonomic dysfunction in patients with Duchenne-type muscular dystrophy [Duchenne musküler distrofi'de kardiyak otonomik disfonksiyonun deǧerlendirilmesi]

Objective: the aim of this study was to investigate the presence of cardiac autonomic dysfunction by time-domain heart rate variability analysis in patients with duchenne muscular dystrophy (dmd). methods: we evaluated cardiac autonomic function by time-domain heart rate variability analysis on 24-hour holter ecg recordings in 43 patients with dmd and 34 healthy male controls. the variability of the heart rate and its circadian rhythm were assessed. the results of time- domain analyses were compared between study and control group. in addition left ventricular end-diastolic diameter,left ventricular ejection fraction and fractional shortening were measured by 2-dimensional echocardiography. results: the mean age of study group was 8.79±3.0 years (range,3 to 17 years),and control group was 9.52±3.1 years (range,4 to 16 years). all of the time-domain parameters (nn,sdnn,sdann,sdnn-i,rmssd,pnn50) of the study group were significantly lower than control group. however no significant difference was found in left ventricular enddiastolic diameter on echocardiographic examination between study and control groups. conclusion: the time-domain parameters were found to be decreased significantly in dmd patients. our data showed a marked impairment of cardiac autonomic function in patinets with dmd,which reflect to mainly involve the parasympathetic activity. we concluded that autonomic dysfunction has developed in the earlier period in dmd before the development of mechanical cardiac dysfunction.