Bisoprolol in DMD Early Cardiomyopathy
Bisoprolol in DMD Early Cardiomyopathy
This study aimed to use cardiac magnetic resonance imaging (CMR) to evaluate the efficacy and
 safety of bisoprolol therapy for boys with Duchenne muscular dystrophy(DMD) and preserved
 ejection fraction. On top of angiotensin-converting enzyme inhibitor (ACEI) , half of the
 participants will receive bisoprolol in combination, while the other half will not receive
 any beta-blocker.
By the age of 20 years, almost all the patients with Duchenne muscular dystrophy(DMD) have
 experienced dilated cardiomyopathy (DCM), a condition that contributes significantly to their
 morbidity and mortality. Studies have shown ACEI to be an effective therapy for DMD boys with
 early cardiomyopathy. Although bisoprolol has been demonstrated as an effective neurohumoral
 drug for adult patients with DCM, few data exist concerning its safety and efficacy for the
 patients with DMD. The investigators hypothesize that the treatment with bisoprolol in
 addition to background ACEI therapy for 12 months in participants with DMD and early
 myocardial damage evident with late gadolinium enhancement and preserved ejection fraction,
 would blunt decline in left ventricular systolic performance.
Inclusion Criteria:

 -  Older than(including) 7 years old

 -  A definite diagnosis of DMD with muscle pathology confirming the expression of
 dystrophin lower than 5% and/or confirmed mutations in the DMD gene using a clinical
 accepted technique that completely defines the mutation.

 -  Using ACEI or ARB for more than 1 month

 -  Confirmed myocardial damage in one or more left ventricular segments evident by late
 gadolinium enhancement and preserved left ventricular systolic function(>45%) by cine
 cardiac MR in 45 days

 -  Normal renal function

 -  Holter and blood pressure shows no contraindication of using bisoprolol

 Exclusion Criteria:

 -  Having metal implanted in body

 -  Having claustrophobia

 -  Allergic to gadolinium

 -  Complicated with other cardiovascular diseases

 -  Medical history or Holter show bradyarrhythmia like II/III degree atrioventricular
 block, sick sinus syndrome etc.

 -  Systolic blood pressure lower than 90mmHg or rest heart rate lower than 75bpm

 -  Having COPD or asthma history

 -  Having other complications: tumor, endocrine diseases

 -  Having beta blockers therapy

 -  Planned operation in the future 12 months

 -  Allergic to bisoprolol