Skip to main content

Advertisement

Log in

Heart involvement in patients with myotonic dystrophy type 2

  • Original Article
  • Published:
Acta Neurologica Belgica Aims and scope Submit manuscript

Abstract

Myotonic dystrophy type 2 (DM2) is a slowly progressive, autosomal-dominant disease. This is a multisystemic disorder that affects the heart, which is one of the main causes of morbidity and mortality in DM2. The aim of the study was to define cardiac impairments in patients with DM2 and its association with sociodemographic and clinical features of patients. This retrospective study comprised 62 adult patients with DM2 hospitalized at the Neurology Clinic, Clinical Center of Serbia from 2013 until 2018, who underwent electrocardiography (ECG) and echocardiography examinations. Hypertension was observed in 42% of DM2 patients. One-fifth of DM2 patients had bradycardia, while other conduction and rhythm impairments were rare. Only one patient had a pacemaker implanted because of the first degree AV block associated with incomplete left bundle branch block. Echocardiography showed diastolic dysfunction of the left ventricle in 44% of patients, while systolic dysfunction was found in only 4%. Cardiomyopathy was observed in 18% of patients, of whom three-fourth had dilated type. Cardiac conduction and rhythm defects are relatively rare in DM2, while diastolic dysfunction is common. This suggests that regular ECG and echocardiography screening is needed in DM2. Adequate therapy should be introduced in patients with DM2 on time to reduce the frequency of heart complications and to prevent premature death.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Finsterer J (2002) Myotonic dystrophy type 2. Eur J Neurol 9(5):441–447

    Article  CAS  PubMed  Google Scholar 

  2. Johnson NE, Heatwole CR (2012) Myotonic dystrophy: from bench to bedside. Semin Neurol 32(3):246–254

    Article  PubMed  Google Scholar 

  3. Feingold B, Mahle WT, Auerbach S, Clemens P, Domenighetti AA, Jefferies JL et al (2017) Circulation. In: Management of cardiac involvement associated with neuromuscular diseases: a scientific statement from the American Heart Association. pp, 1–31

  4. Stojanovic VR, Peric S, Paunic T, Pavlovic S, Cvitan E, Basta I et al (2013) Cardiologic predictors of sudden death in patients with myotonic dystrophy type 1. J Clin Neurosci 20(7):1002–1006

    Article  Google Scholar 

  5. Sansone VA, Brigonzi E, Schoser B, Villani S, Gaeta M, De Ambroggi G et al (2013) The frequency and severity of cardiac involvement in myotonic dystrophy type 2 (DM2): long-term outcomes. Int J Cardiol 168(2):1147–1153

    Article  CAS  PubMed  Google Scholar 

  6. Meola G, Cardani R (2015) Myotonic dystrophies: an update on clinical aspects, genetic, pathology, and molecular pathomechanisms. Biochem Biophys Acta 1852:594–606

    CAS  PubMed  Google Scholar 

  7. Wahbi K, Meune C, Bécane HM, Laforêt P, Bassez G, Lazarus A et al (2009) Left ventricular dysfunction and cardiac arrhythmias are frequent in type 2 myotonic dystrophy: a case control study. Neuromuscul Disord 19(7):468–472

    Article  PubMed  Google Scholar 

  8. Choudhary P, Nandakumar R, Greig H, Broadhurst P, Dean J, Puranik R et al (2016) Structural and electrical cardiac abnormalities are prevalent in asymptomatic adults with myotonic dystrophy. Heart 102(18):1472–1478

    Article  CAS  PubMed  Google Scholar 

  9. Schara U, Schoser BGH (2006) Myotonic dystrophies type 1 and 2: a summary on current aspects. Semin Pediatr Neurol 13(2):71–79

    Article  PubMed  Google Scholar 

  10. Udd B, Krahe R (2012) The myotonic dystrophies: molecular, clinical, and therapeutic challenges. Lancet Neurol 11(10):891–905

    Article  CAS  PubMed  Google Scholar 

  11. Peric S, Maksimovic R, Banko B, Durdic M, Bjelica B, Bozovic I, Balcik Y, Pesovic J, Savic-Pavicevic D, Rakocevic-Stojanovic V (2017) Magnetic resonance imaging of leg muscles in patients with myotonic dystrophies. J Neurol 264(9):1899–1908

    Article  CAS  PubMed  Google Scholar 

  12. Paunic T, Peric S, Cvitan E, Raspopovic S, Peric M, Mandic Stojmenovic G et al (2017) Routine echocardiography in patients with myotonic dystrophy type 1. J Chinese Med Assoc 80(7):408–412

    Article  Google Scholar 

  13. Vujnic M, Peric S, Popovic S, Raseta N, Ralic V, Dobricic V et al (2015) Metabolic syndrome in patients with myotonic dystrophy type 1. Muscle Nerve 52(2):273–277

    Article  CAS  PubMed  Google Scholar 

  14. Ha AH, Tarnopolsky MA, Bergstra TG, Nair GM, Al-qubbany, Healey JS (2012) Predictors of atrio-ventricular conduction disease, long-term outcomes in patients with myotonic dystrophy types I and II. Pacing Clin Electrophysiol 35(10):1262–1269

    Article  PubMed  Google Scholar 

  15. Yang G, Sau C, Lai W, Cichon J, Li W (2015) HHS Public Access 344(6188):1173–1178

    Google Scholar 

  16. Montagnese F, Mondello S, Wenninger S, Kress W, Schoser B (2017) Assessing the influence of age and gender on the phenotype of myotonic dystrophy type 2. J Neurol 264(12):2472–2480

    Article  PubMed  Google Scholar 

  17. Schoser BG, Ricker K, Schneider-Gold C, Hengstenberg C, Dürre J, Bültmann B, Kress W, Day JW, Ranum LP (2004) Sudden cardiac death in myotonic dystrophy type 2. Neurology 63(12):2402–2404

    Article  CAS  PubMed  Google Scholar 

  18. Perfetti A, Greco S, Fasanaro P, Bugiardini E, Cardani R, Garcia-Manteiga JM, Riba M, Cittaro D, Stupka E, Meola G, Martelli F (2014) Genome wide identification of aberrant alternative splicing events in myotonic dystrophy type 2. PLoS One 9(4):e93983

    Article  PubMed  PubMed Central  Google Scholar 

  19. Schmacht L, Traber J, Grieben U, Utz W, Dieringer MA, Kellman P et al (2016) Cardiac involvement in myotonic dystrophy type 2 patients with preserved ejection fraction: Detection by cardiovascular magnetic resonance. Circ Cardiovasc Imaging 9(7):1–11

    Article  Google Scholar 

  20. Romeo V (2012) Myotonic dystrophy type 1 or Steinert’s disease. Adv Exp Med Biol 724:239–257

    Article  CAS  PubMed  Google Scholar 

  21. Bhatia RS, Tu JV, Lee DS, Austin PC, Fang J, Haouzi A et al (2006) Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med 355(3):260–269

    Article  CAS  PubMed  Google Scholar 

  22. Lau JK, Sy RW, Corbett A, Kritharides L (2015) Myotonic dystrophy and the heart: a systematic review of evaluation and management. Int J Cardiol 184(1):600–608

    Article  CAS  PubMed  Google Scholar 

  23. Mace CR, Akbulut O, Kumar AA, Shapiro ND, Derda R, Patton MR et al (2014) NIH Public Access 134(22):1–10

    Google Scholar 

Download references

Acknowledgements

This study was supported by the Ministry of Education, Science and Technological Development of the Republic of Serbia (Grant #175083).

Funding

This study was funded by the Ministry of Education, Science and Technological Development of the Republic of Serbia (Grant #175083).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Vidosava Rakocevic Stojanovic.

Ethics declarations

Conflict of interest

Stojan Peric declares that he has no conflict of interest. Bogdan Bjelica declares that he has no conflict of interest. Ksenija Aleksic declares that she has no conflict of interest. Masa Kovacevic declares that she has no conflict of interest. Edita Cvitan declares that she has no conflict of interest. Gorana Mandic Stojmenovic declares that she has no conflict of interest. Vidosava Rakocevic Stojanovic declares that she has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Peric, S., Bjelica, B., Aleksic, K. et al. Heart involvement in patients with myotonic dystrophy type 2. Acta Neurol Belg 119, 77–82 (2019). https://doi.org/10.1007/s13760-018-1052-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13760-018-1052-3

Keywords

Navigation