DMD Gene Variants and Cardiac Dysfunction in Young Males With Dystrophinopathies

Pathogenic variants in the DMD gene lead to a spectrum of clinical phenotypes known as dystrophinopathies, with Duchenne muscular dystrophy and Becker muscular dystrophy representing the most common forms. Beyond progressive skeletal muscle weakness, a substantial proportion of patients have cardiac involvement, often progressing to dilated cardiomyopathy -a major cause of morbidity and the leading cause of mortality in this population. Although cardiac involvement is well recognized in dystrophinopathies, the relationship between specific DMD gene variants and the severity or pattern of cardiac dysfunction has not been fully clarified.

This observational pilot study is designed to investigate the association between the type, location, and extent of pathogenic variants in the DMD gene and cardiac dysfunction in male children, adolescents, and young adults aged 2 to 24 years with genetically confirmed dystrophinopathies. In addition to evaluating genotype-cardiac phenotype associations, the study explores whether cardiac biomarkers, electrocardiographic abnormalities, age, ongoing pharmacological treatment, and lipid-related parameters, including non-HDL cholesterol, are associated with early cardiac involvement.

Participants will undergo a structured clinical and cardiac evaluation, including collection of demographic and clinical data, medical history, pharmacological treatment, and comorbidities. Blood samples will be collected at the baseline assessment for measurement of cardiac biomarkers and lipid-related parameters. Cardiological evaluation will be performed in all participants and will comprise electrocardiography and transthoracic echocardiography. Echocardiographic assessment will include both conventional and deformation-based indices of left ventricular systolic function, including ejection fraction and global longitudinal strain.

By integrating genetic, biochemical, electrocardiographic, and echocardiographic data, this multidimensional approach seeks to improve understanding of genotype-cardiac phenotype associations, facilitate earlier recognition of cardiac involvement, and contribute to more individualized monitoring and clinical management in patients with dystrophinopathies.

• Frequency of electrocardiographic abnormalities in participants with and without cardiac dysfunction [Срок оценки: On the day of the baseline assessment]
• Blood levels of high-sensitivity troponin T in participants with and without cardiac dysfunction [Срок оценки: On the day of the baseline assessment]
• Blood levels of NT-proBNP in participants with and without cardiac dysfunction [Срок оценки: On the day of the baseline assessment]
• Correlation between age and the presence of cardiac dysfunction [Срок оценки: On the day of the baseline assessment]
• Ongoing pharmacological treatment in participants with and without cardiac dysfunction [Срок оценки: On the day of the baseline assessment]
• Non-HDL cholesterol levels in participants with and without cardiac dysfunction [Срок оценки: On the day of the baseline assessment]