{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T09:39:06Z","timestamp":1786441146104,"version":"build-2736575974"},"reference-count":32,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Administraci\u00f3n del Patrimonio de la Beneficencia P\u00fablica through the Asociaci\u00f3n de Distrofia Muscular de Occidente A.C.","award":["APBP 2012"],"award-info":[{"award-number":["APBP 2012"]}]},{"name":"Fondo Semila-UAG","award":["CS-FS-2026-022"],"award-info":[{"award-number":["CS-FS-2026-022"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Muscles"],"abstract":"<jats:p>Background: Pathogenic variants in the DMD gene are a frequently overlooked cause of dilated cardiomyopathy (DCM) in idiopathic cases, especially when skeletal myopathy is mild or seemingly absent. Becker muscular dystrophy (BMD) and X-linked dilated cardiomyopathy are at opposite ends of this clinical spectrum but result from pathogenic variants in the same gene. Cardiomyopathy is a major cause of premature death in muscular dystrophies. Case presentation: We describe a 37-year-old man who underwent orthotopic heart transplantation for presumed idiopathic DCM with refractory heart failure. He had a six-year history of progressive proximal weakness, pseudohypertrophy of the calf, a positive Gowers sign, and markedly elevated creatine kinase (6638 IU\/L). Multiplex ligation-dependent probe amplification (MLPA) revealed an in-frame deletion of exons 45\u201347 of DMD [c. (6438+1_6439-1)_(6912+1_6913-1) del; NM_004006.2], confirming BMD. Immunofluorescence showed reduced and patchy dystrophin expression. Conclusions: To our knowledge, this is the first documented heart transplant in a patient with BMD in Mexico. This case demonstrates the value of considering muscular dystrophy in the differential diagnosis of apparently idiopathic dilated cardiomyopathy (DCM), a step that opens the door to accurate diagnosis, carrier screening, and genetic counseling, and supports the view that heart transplantation is a viable option in carefully selected patients with muscular dystrophy cardiomyopathy.<\/jats:p>","DOI":"10.3390\/muscles5030057","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T08:09:36Z","timestamp":1786435776000},"page":"57","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mexico\u2019s First Heart Transplant in a Patient with Becker Muscular Dystrophy Reveals an Overlooked Cause of Idiopathic Dilated Cardiomyopathy"],"prefix":"10.3390","volume":"5","author":[{"given":"Norma Alejandra","family":"V\u00e1zquez-C\u00e1rdenas","sequence":"first","affiliation":[{"name":"Life Cycle Department, Universidad Aut\u00f3noma de Guadalajara, Av. Patria 1201, Zapopan 45129, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1760-3150","authenticated-orcid":false,"given":"Silvia","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City 03104, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha Eunice","family":"Rodr\u00edguez Arellano","sequence":"additional","affiliation":[{"name":"Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City 03104, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2509-4923","authenticated-orcid":false,"given":"Benjam\u00edn","family":"G\u00f3mez-D\u00edaz","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Rehabilitaci\u00f3n Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delia Carolina","family":"L\u00f3pez Vargas","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n de Distrofia Muscular de Occidente A.C., Guadalajara 44380, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3912-6754","authenticated-orcid":false,"given":"Luz Berenice","family":"L\u00f3pez-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Life Cycle Department, Universidad Aut\u00f3noma de Guadalajara, Av. Patria 1201, Zapopan 45129, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1002\/mus.20586","article-title":"Entries in the Leiden Duchenne Muscular Dystrophy Mutation Database: An Overview of Mutation Types and Paradoxical Cases That Confirm the Reading-Frame Rule","volume":"34","author":"Fokkema","year":"2006","journal-title":"Muscle Nerve"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1002\/ejhf.2284","article-title":"The Heart of Dystrophinopathies","volume":"23","author":"Sinagra","year":"2021","journal-title":"Eur. J. Heart Fail."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3733","DOI":"10.1007\/s00415-023-11796-x","article-title":"Duchenne Muscular Dystrophy: Pathogenesis and Promising Therapies","volume":"270","author":"Chang","year":"2023","journal-title":"J. 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