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Clinical profiles and prognosis of acute heart failure in adult patients with dystrophinopathies on home mechanical ventilation.
- Source :
-
ESC heart failure [ESC Heart Fail] 2017 Nov; Vol. 4 (4), pp. 527-534. Date of Electronic Publication: 2017 May 18. - Publication Year :
- 2017
-
Abstract
- Aims: Duchenne muscular dystrophy (DMD) is characterized by respiratory and heart involvements. In the context of permanently wheelchair bound and on mechanical ventilation (MV) patients, the clinical presentation of acute heart failure (AHF) syndrome may be atypical. We sought to describe clinical and genetic profiles and to determine prognosis of DMD and Becker muscular dystrophy (BMD) patients on home MV (HMV), hospitalized for AHF.<br />Methods and Results: We included genetically proven DMD and BMD patients on HMV admitted for AHF. A total of 13 patients (11 DMD and 2 BMD) fulfilled the inclusion criteria. Median age was 34.0 [interquartile range (IQR) 26.0; 40.0] years. Median pulmonary vital capacity was 9.0% (6.0; 15.0) of predicted value. Long-term invasive ventilation was performed in 69% of patients. All the 11 DMD patients carried out-of-frame DMD gene mutations. At admission, dyspnoea was present in 46%, lipothymia in 23%, and abdominal discomfort in 38.4% of patients. A total of 53.8% of patients showed anasarca. Cardiogenic shock presentation was found in six patients (46%). Ejection fraction was severely altered [median 25% (IQR 20; 30)]. Intra-hospital mortality rate was 30%, reaching 53.8 % after 1 year. Previous episodes of AHF ≥ 2 were associated with intra-hospital mortality (P = 0.025). In patients with cardiogenic shock, intra-hospital mortality rate was 66.6%, reaching 83.3% after 1 year.<br />Conclusions: In adult DMD and BMD patients with severe ejection fraction alteration and on HMV, admitted for AHF, right cardiac signs are frequent. The intra-hospital and 1 year mortality rate was high and was associated with previous episodes of AHF ≥ 2.<br /> (© 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.)
- Subjects :
- Acute Disease
Adult
Female
Follow-Up Studies
France epidemiology
Heart Failure mortality
Heart Failure physiopathology
Humans
Male
Middle Aged
Muscular Dystrophy, Duchenne mortality
Muscular Dystrophy, Duchenne therapy
Prognosis
Retrospective Studies
Survival Rate trends
Time Factors
Young Adult
Heart Failure complications
Home Care Services
Muscular Dystrophy, Duchenne complications
Respiration, Artificial methods
Stroke Volume physiology
Subjects
Details
- Language :
- English
- ISSN :
- 2055-5822
- Volume :
- 4
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- ESC heart failure
- Publication Type :
- Academic Journal
- Accession number :
- 29154419
- Full Text :
- https://doi.org/10.1002/ehf2.12165