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We conducted a prospective 7-year follow-up study to investigate the evolution of ventricular function, myocardial fibrosis, and arrhythmias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      34 women with confirmed pathogenic\n                      <jats:italic>DMD<\/jats:italic>\n                      gene variants (19 predicted to cause Duchenne muscular dystrophy and 15 Becker muscular dystrophy) underwent assessments after a mean of 7\u00a0years. Evaluations included cardiac magnetic resonance imaging with late gadolinium enhancement, 24-h Holter monitoring, 12-lead electrocardiography (ECG), cardiac biomarkers, and clinical examinations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At the group level, left ventricular ejection fraction (LVEF) remained stable over follow-up (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.403). Six women had a\u2009\u2265\u20095% change in LVEF: three improved with treatment, and three declined by 5\u20138%. Fibrosis was present in 9 women at both baseline and follow-up; 3 showed visual progression, and no new cases were identified. Although the median ventricular premature contractions per hour (VPC\/h) increased from 0.23\/h to 6.38\/h (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), this increase is likely not clinically meaningful as age-related increases in ventricular ectopy are also seen in healthy populations, and high-burden arrhythmias\u2014according to prespecified thresholds\u2014remained uncommon.\n                    <\/jats:p>\n                    <jats:p>ECG parameters remained stable (PR, QRS, and QTc unchanged), with no new bundle-branch blocks or high-grade atrioventricular block detected. No association was observed between LVEF, VPC\/h, and supraventricular premature contraction per hour over the 7-year follow-up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Over 7\u00a0years, women carrying pathogenic\n                      <jats:italic>DMD<\/jats:italic>\n                      gene variants have very little or no progression of cardiac findings (LVEF, fibrosis, and arrhythmias). Given these findings, frequent routine rhythm monitoring is not indicated. Follow-up should be risk-stratified: closer for women with symptoms, baseline high-burden ectopy, reduced LVEF, or pre-existing fibrosis; others can be reviewed at extended intervals.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-026-13856-4","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T18:37:35Z","timestamp":1779302255000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Natural history of cardiac involvement in women carrying pathogenic DMD gene variants: a 7-year longitudinal study"],"prefix":"10.1007","volume":"273","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5376-9793","authenticated-orcid":false,"given":"Zhe","family":"Lyu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heini","family":"Joensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanna Scharff","family":"Poulsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Buhl","family":"Hjortrup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Slipsager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f8rk","family":"Teitsd\u00f3ttir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freja","family":"Fornander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuva \u00c5satun","family":"Solheim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam Espe","family":"Hansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels Grove","family":"Vejlstrup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Vissing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"issue":"8-9","key":"13856_CR1","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/0753-3322(94)90052-3","volume":"48","author":"L Cyril","year":"1994","unstructured":"Cyril L, Ruth S, Mathias G, Yosef S (1994) A molecular survey of Israeli Duchenne and Becker muscular dystrophy patients. 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