Duchenne muscular dystrophy (DMD) is the most common form of inherited muscle disease in children. The incidence of cardiomyopathy induced by DMD increases with age. Left ventricular ejection fraction usually fails to reflect the subclinical left ventricular dysfunction. Several studies have assessed this dysfunction using myocardial strain measured by speckle-tracking echocardiography (STE). However, the results were inconsistent and incomplete. Several databases were searched from their inception to February 5, 2020. The summarized weighted mean difference (WMD) with 95% confidence intervals (CIs) were estimated for myocardial strain between DMD and healthy controls and a meta-analysis was conducted. Trial sequential analysis estimated whether the resulting evidence was sufficient. Eight studies with a total of 269 DMD children and 299 healthy participants were included. STE revealed that global longitudinal strain (GLS), global circumferential strain, average longitudinal strain (measured by two-dimensional STE at the apical four-chamber view), and average circumferential strain (measured by two-dimensional STE at the papillary muscle short-axis level) decreased (WMD = 4.17, 95% CI: 3.03–5.32; WMD = 3.98, 95% CI: 0.29–7.68; WMD = 4.18, 95% CI: 2.75–5.62; and WMD = 4.90, 95% CI: 2.38–7.43, respectively; all P < 0.05) compared with the controls and global radial strain was unchanged in the DMD group (WMD = − 4.33, 95% CI: − 9.53–0.87, P = 0.103). Trial sequential analysis indicated that available GLS samples were sufficient and confirmed that adequate evidence was accumulated. The credibility of other myocardial strains was questioned due to insufficiently involved studies. GLS can be useful for early detection of left ventricle myocardial dysfunction in children with DMD.

中文翻译：

---

斑点跟踪超声心动图对早期发现杜兴氏肌营养不良症儿童的有用性：一项荟萃分析和试验性顺序分析。

杜兴氏肌营养不良症（DMD）是儿童遗传性肌肉疾病的最常见形式。DMD引起的心肌病的发病率随年龄增长而增加。左心室射血分数通常不能反映亚临床的左心室功能障碍。几项研究已使用斑点追踪超声心动图（STE）测量的心肌张力评估了这种功能障碍。但是，结果不一致且不完整。从数据库开始到2020年2月5日，对几个数据库进行了搜索。估计了DMD与健康对照组之间心肌应变的汇总加权均数差（WMD）和95％置信区间（CIs），并进行了荟萃分析。试验顺序分析估计了得出的证据是否足够。包括八项研究，共269名DMD儿童和299名健康参与者。STE揭示了整体纵向应变（GLS），整体周向应变，平均纵向应变（在心尖四腔视图上由二维STE测量）和平均周向应变（在乳头肌短小处由二维STE测量）轴水平）降低（WMD = 4.17，95％CI：3.03–5.32; WMD = 3.98，95％CI：0.29–7.68; WMD = 4.18，95％CI：2.75–5.62; WMD = 4.90，95％CI：与对照组相比，DMD组分别为2.38–7.43；所有P <0.05）和总体径向应变均未改变（WMD = − 4.33，95％CI：− 9.53–0.87，P = 0.103）。试验顺序分析表明，可用的GLS样品已足够，并确认已积累了足够的证据。由于缺乏足够的研究，其他心肌菌株的可信度受到质疑。GLS有助于DMD儿童早期发现左心室心肌功能障碍。