Comparative efficacy of methods for early diagnosis of myocardial involvement in Duchenne and Becker muscular dystrophies

Introduction. Cardiomyopathy is the leading cause of mortality in dystrophinopathies. Standard screening methods often fail to detect early preclinical changes. The aim of the study was a comparative assessment of the diagnostic value of modern methods (global longitudinal strain — GLS, 24-hour ECG monitoring — Holter monitoring, myocardial damage biomarkers) in detecting early cardiac dysfunction.

Materials and methods. A prospective cross-sectional study included thirty one patient with Duchenne/Becker muscular dystrophy (DMD/BMD). All patients underwent comprehensive assessment including echocardiography with GLS analysis, 24-hour Holter monitoring, determination of NT-proBNP and troponin I levels.

Results. Reduced left ventricular ejection fraction (LVEF < 50%) was detected in 5 patients (16.1%). In patients with preserved LVEF, subclinical reduction in GLS was noted in 68.8%. Holter monitoring detected tachycardia significantly more often than a single ECG recording (p < 0.050), as well as a combination of tachycardia with reduced heart rate variability and high ventricular ectopic activity. The NT-proBNP level was significantly higher in the group with LVEF < 50% (279.8 [73.28; 844.8] vs. 60.83 [34.24; 104.5] pg/mL, p = 0.020).

Conclusion. Speckle-tracking echocardiography and 24-hour Holter monitoring have significantly higher sensitivity in detecting preclinical cardiomyopathy in DMD/BMD compared to standard screening. Their combined use with the determination of NT-proBNP and troponin I allows the risk stratificating and justifying early initiation of cardioprotective therapy.

Contributions:
Kaverina V.G. — writing the text;
Sdvigova N.A. — writing, editing the text;
Silnova I.V. — writing, editing the text;
Popovich S.G. — writing, editing the text;
Uvakina E.V. — writing, editing the text;
Basargina E.N. — conception and design of the article, writing the text, editing;
Kuzenkova L.M. — conception and design of the article, writing the text, editing.
All co-authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: December 1, 2025
Accepted: December 22, 2025
Published: January 31, 2026

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