A cardiac perspective for management of dystrophinopathies

Cardiac disease is a leading cause of death in Duchenne and Becker muscular dystrophy, with dilated cardiomyopathy and arrhythmias nearly ubiquitous by adulthood. Guideline-directed surveillance with echocardiography, cardiac MRI, and rhythm monitoring enables early initiation of ACE inhibitors, beta-blockers, and mineralocorticoid receptor antagonists, which delay progression and improve survival. Multidisciplinary cardio-neuromuscular clinics further enhance outcomes by integrating surveillance, timely device therapy, and advanced interventions. Proactive interdisciplinary care is thus essential to preserving function and extending survival in dystrophinopathies.