{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T12:11:46Z","timestamp":1783512706499,"version":"3.55.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,10,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients with Duchenne muscular dystrophy (DMD) develop cardiomyopathy because of a dystrophin deficiency causing fibrofatty replacement of the myocardium. Corticosteroid use and mobility limitations place these patients at risk for increased adiposity. We sought to determine the association of adiposity with cardiovascular dysfunction in patients with DMD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This was a retrospective review of patients with DMD who underwent both cardiac magnetic resonance imaging and dual\u2010energy x\u2010ray absorptiometry within 1\u00a0year. The cardiac magnetic resonance imaging parameters included left ventricular ejection fraction and the presence of late gadolinium enhancement (LGE positive [LGE+]). The adiposity indices, measured by dual\u2010energy x\u2010ray absorptiometry, included percentage of body fat, whole body fat mass indexed to height, and body mass index. A total of 324 patients were identified. Fifty\u2010two percent had LGE+, and 36% had cardiac dysfunction (left ventricular ejection fraction &lt;55%). Patients with cardiac dysfunction had higher whole body fat mass indexed to height and body mass index on univariate analysis (mean difference between patients with and without cardiac dysfunction: +2.9\u00a0kg\/m,\n              <jats:italic>P<\/jats:italic>\n              =0.001; and +1.5\u00a0kg\/m\n              <jats:sup>2<\/jats:sup>\n              ,\n              <jats:italic>P<\/jats:italic>\n              =0.03, respectively). whole body fat mass indexed to height remained independently associated with cardiac dysfunction on multivariable analysis after adjusting for age, LGE+, and corticosteroid duration. High whole body fat mass indexed to height and percentage of body fat were associated with LGE+ on univariate analysis (mean difference between patients with and without LGE+: +2.0\u00a0kg\/m,\n              <jats:italic>P<\/jats:italic>\n              =0.02; and +2.4%,\n              <jats:italic>P<\/jats:italic>\n              =0.02, respectively). Using multivariable analysis, including age and cardiac dysfunction, high percentage of body fat remained independently associated with LGE+.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">This study demonstrates an independent association of adiposity with cardiac dysfunction and LGE+ in patients with DMD. Preventing adiposity may mitigate the later development of ventricular dysfunction in DMD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.021037","type":"journal-article","created":{"date-parts":[[2021,9,25]],"date-time":"2021-09-25T14:42:45Z","timestamp":1632580965000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["The Effect of Adiposity on Cardiovascular Function and Myocardial Fibrosis in Patients With Duchenne Muscular Dystrophy"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4317-3246","authenticated-orcid":false,"given":"Sarah E.","family":"Henson","sequence":"first","affiliation":[{"name":"Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean M.","family":"Lang","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2611-8835","authenticated-orcid":false,"given":"Philip R.","family":"Khoury","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH"},{"name":"Heart Institute Research Core Cincinnati Children's Hospital Medical Center Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuixia","family":"Tian","sequence":"additional","affiliation":[{"name":"Neurology, Cincinnati Children\u2019s Hospital Medical Center Cincinnati OH"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4142-9527","authenticated-orcid":false,"given":"Meilan M.","family":"Rutter","sequence":"additional","affiliation":[{"name":"Endocrinology, Cincinnati Children\u2019s Hospital Medical Center Cincinnati OH"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5640-6777","authenticated-orcid":false,"given":"Elaine M.","family":"Urbina","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas D.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0251-8017","authenticated-orcid":false,"given":"Michael D.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3777-4822","authenticated-orcid":false,"given":"Tarek","family":"Alsaied","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology and Heart Institute, University of Pittsburgh Medical Center Children\u2019s Hospital of Pittsburgh Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2008.01.018"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-0333N"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000526"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-2448"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30025-5"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/1532-429X-15-107"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.114.001338"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.10.078"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-008-9352-y"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.07.042"},{"key":"e_1_3_1_12_2","first-page":"CD003725","article-title":"Corticosteroids for the treatment of Duchenne muscular dystrophy","author":"Matthews E","year":"2016","unstructured":"Matthews E, Brassington R, Kuntzer T, Jichi F, Manzur AY. 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