Table 1.
II-3 | II-4 | III-1 | |
---|---|---|---|
Current Age (yrs: In 2013) | 14† | 15 | 7 |
Diagnosis of BMD (yrs) | 6 | 3 | 3 |
Diagnosis of DCM (yrs) | 11 2/3 | 11 3/4 | N/A |
| |||
Neurological | Normal | Seizure disorder (resolved) | Mild developmental delay |
Behavioral & Developmental | ADHD | Mild cognitive delay | ADHD |
| |||
Musculoskeletal | Mild muscle weakness | Mild muscle weakness | Mild muscle weakness |
Serum CK (IU/L) | 38,256 | >16,000 | 13,860 |
Muscle Biopsy | (+) | (+) | Not performed |
Immunohistochemistry | Severely decreased dystrophin protein | Figure 1 | |
Western blot (protein quantification) | Severely decreased (3 to 10%) | Severely decreased (3 to 10%) | |
| |||
Cardiac | Severe CHF | Severe CHF | None |
ECG | Sinus tachycardia (130) | T wave inversion in V5, V6 | Normal |
RVH, RAH, LVH | LVH | ||
CXR | Cardiomegaly | Cardiomegaly | Not done |
Echocardiogram | Dilated LV (LVIDd 6.2 cm) | Dilated LV (LVIDd 7.7 cm) | Normal study |
LVSF < 10% | LVSF 15% | ||
Cardiac Catheterization | 13 yrs 10 mos | 14 yrs 0 mos | Not performed |
SvO2: 54%, SaO2 93% | SvO2 70 %, SaO2 99% | ||
RA (10) mmHg, LDEDP 35 mmHg | RA (3) mmHg, LVEDP 12 mmHg | ||
C.I. 1.8 L/min/m2, Rp/Rs = 0.43 | C.I. 2.1 L/min/m2, Rp/Rs = 0.28 | ||
Mechanically ventilated (FiO2 0.5) | On milrinone infusion | ||
On milrinon infusion |
†: Deceased. BMD: Becker muscular dystrophy, DCM: dilated cardiomopathy, ADHD: attention deficit hyperactivity disorder, CK: creatine kinase, CHF: congestive heart failure, RVH: right ventricular hypertrophy, RAH: right atrial hypertrophy, LVH: left ventricular hypertrophy, LVIDd: left ventricular internal diameter in diastole, LVSF: left ventricular shortening fraction, SvO2: mixed venous saturation, SaO2: systemic arterial saturation, RA: right atrial pressure (mean), LVEDP: left ventricular end diastolic pressure, C.I.: cardiac index, Rp/Rs: Pulmonary vascular resistance/systemic vascular resistance.