{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:54:00Z","timestamp":1781636040416,"version":"3.54.5"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Cardiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Duchenne muscular dystrophy\u2013associated cardiomyopathy (DMDAC) is a leading cause of mortality in patients with Duchenne muscular dystrophy. Conventional reliance on ejection fraction (EF) may underestimate early myocardial dysfunction. This study utilized the previously published dataset by Ajiboye et al. (Heart Vessels 40(8):696\u2013706, 2025) comprising 30 DMDAC patients who underwent serial cardiac magnetic resonance (CMR) imaging between 2014 and 2023. Noninvasive indices\u2014mean elastance, contractility, and energy efficiency\u2014were derived using an innovative optimization approach by integrating patients specific brachial blood pressure and CMR-based left-ventricular volume changes. Diagnostic performance of the proposed indices relative to EF\u2009&lt;\u200955% was obtained using receiver operating characteristic (ROC) curve to determing the cut-off values. All three indices, derived noninvasively, demonstrated statistically significant delineation for 55% EF, with AUC of 0.92 for mean elastance, 0.96 for contractility, and 1.00 for energy efficiency. Optimal cut-offs were 0.50 mmHg\/mL, 1.72 mmHg\/mL, and 69.8%, respectively. These findings support\n                    <jats:italic>newly developed<\/jats:italic>\n                    mean elastance, contractility, and energy efficiency as viable noninvasive diagnostic indices for DMDAC. Incorporating these indices alongside EF could improve early detection and risk stratification in clinical decision making.\n                  <\/jats:p>","DOI":"10.1007\/s00246-026-04188-1","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T05:25:52Z","timestamp":1770873952000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Cut-off Values for Newly Developed Noninvasive Elastance-Based Indices in Duchenne Muscular Dystrophy\u2013Associated Cardiomyopathy"],"prefix":"10.1007","author":[{"given":"Israel O.","family":"Ajiboye","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupak K.","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,14]]},"reference":[{"issue":"11","key":"4188_CR1","doi-asserted-by":"publisher","first-page":"3175","DOI":"10.1093\/brain\/awp236","volume":"132","author":"FL Norwood","year":"2009","unstructured":"Norwood FL, Harling C, Chinnery PF, Eagle M, Bushby K, Straub V (2009) Prevalence of genetic muscle disease in Northern England: in-depth analysis of a muscle clinic population. Brain 132(11):3175\u20133186","journal-title":"Brain"},{"issue":"21","key":"4188_CR2","doi-asserted-by":"publisher","first-page":"2533","DOI":"10.1016\/j.jacc.2016.02.081","volume":"67","author":"F Kamdar","year":"2016","unstructured":"Kamdar F, Garry DJ (2016) Dystrophin-deficient cardiomyopathy. J Am Coll Cardiol 67(21):2533\u20132546","journal-title":"J Am Coll Cardiol"},{"issue":"10","key":"4188_CR3","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1016\/j.nmd.2023.09.004","volume":"33","author":"P Karachunski","year":"2023","unstructured":"Karachunski P, Townsend D (2023) Systemic under treatment of heart disease in patients with Duchenne muscular dystrophy. Neuromuscul Disord 33(10):776\u2013781","journal-title":"Neuromuscul Disord"},{"issue":"11","key":"4188_CR4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.120.011526","volume":"13","author":"S Siddiqui","year":"2020","unstructured":"Siddiqui S, Alsaied T, Henson SE, Gandhi J, Patel P, Khoury P, Villa C, Ryan TD, Wittekind SG, Lang SM, Taylor MD (2020) Left ventricular magnetic resonance imaging strain predicts the onset of Duchenne muscular dystrophy-associated cardiomyopathy. Circ Cardiovasc Imaging 13(11):e011526","journal-title":"Circ Cardiovasc Imaging"},{"issue":"10","key":"4188_CR5","doi-asserted-by":"publisher","first-page":"3186","DOI":"10.3390\/jcm9103186","volume":"9","author":"R Adorisio","year":"2020","unstructured":"Adorisio R, Mencarelli E, Cantarutti N, Calvieri C, Amato L, Cicenia M, Silvetti M, D\u2019Amico A, Grandinetti M, Drago F, Amodeo A (2020) Duchenne dilated cardiomyopathy: cardiac management from prevention to advanced cardiovascular therapies. J Clin Med 9(10):3186","journal-title":"J Clin Med"},{"issue":"Supplement2","key":"4188_CR6","doi-asserted-by":"publisher","first-page":"S72","DOI":"10.1542\/peds.2018-0333I","volume":"142","author":"S Buddhe","year":"2018","unstructured":"Buddhe S, Cripe L, Friedland-Little J, Kertesz N, Eghtesady P, Finder J, Hor K, Judge DP, Kinnett K, McNally EM (2018) Cardiac management of the patient with Duchenne muscular dystrophy. Pediatrics 142(Supplement2):S72\u2013S81","journal-title":"Pediatrics"},{"issue":"1","key":"4188_CR7","doi-asserted-by":"publisher","first-page":"e2260","DOI":"10.1002\/bdr2.2260","volume":"116","author":"KM Conway","year":"2024","unstructured":"Conway KM, Thomas S, Ciafaloni E, Khan RS, Mann JR, Romitti PA, Mathews KD, Muscular Dystrophy Surveillance, Tracking and Research Network (MD STARnet) (2024) Prophylactic use of cardiac medications for delay of left ventricular dysfunction in Duchenne muscular dystrophy. Birth Defects Res 116(1):e2260","journal-title":"Birth Defects Res"},{"key":"4188_CR8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ppedcard.2024.101802","volume":"76","author":"IO Ajiboye","year":"2025","unstructured":"Ajiboye IO, Taylor MD, Banerjee RK (2025) Non-invasive pressure-volume loop derived LV efficiency, contractility, and stroke work in patients with Duchenne muscular dystrophy. Prog Pediatr Cardiol 76:101802","journal-title":"Prog Pediatr Cardiol"},{"issue":"8","key":"4188_CR9","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1007\/s00380-024-02511-5","volume":"40","author":"IO Ajiboye","year":"2025","unstructured":"Ajiboye IO, Lang SM, Taylor MD, Banerjee RK (2025) Non-invasive pressure\u2013volume loop derived temporal elastance, contractility, and efficiency indices for assessing Duchenne muscular dystrophy patients. Heart Vessels 40(8):696\u2013706","journal-title":"Heart Vessels"}],"container-title":["Pediatric Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-026-04188-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00246-026-04188-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-026-04188-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:07:49Z","timestamp":1781633269000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00246-026-04188-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,14]]},"references-count":9,"alternative-id":["4188"],"URL":"https:\/\/doi.org\/10.1007\/s00246-026-04188-1","relation":{},"ISSN":["0172-0643","1432-1971"],"issn-type":[{"value":"0172-0643","type":"print"},{"value":"1432-1971","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,14]]},"assertion":[{"value":"28 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}]}}