Myotonic dystrophy patients: More data about cardiac and neurologic findings would be useful

Abstract

With interest, we read the article by Schmid et al. about cardiac involvement in a cross-sectional cohort of myotonic dystrophies and other skeletal myopathies. We have the following questions and concerns: Neuromuscular disorders may be associated with left ventricular hypertrabeculation/non-compaction (LVHT). Was search for LVHT also carried out by echocardiography and cardiac magnetic resonance imaging and in how many cases were the findings indicative of LVHT? It remains unclear why patients with concomitant cardiac disease were excluded. In how many patients was coronary angiography carried out? In how many patients was the family history positive for cardiac disease? We miss a description of the neurologic impairment of the included patients. Was there any relationship between the severity of the neurologic symptoms and the cardiac findings? Was there any genotype—phenotype correlation? No data about the pharmacotherapy and are given. It would be interesting to know if patients with systolic dysfunction received neurohumoral therapy. Furthermore, it should be reported how many patients with syncope or palpitation in their history had received devices for arrhythmia monitoring like implantable loop recorders which have been shown to be useful tools in patients with myotonic dystrophies. The baseline data were collected from June 2014 to June 2016. Thus, it would be of interest if follow-up investigations were carried out in the meantime. Did the intervals at which cardiac investigations were scheduled depend on the actual findings? Was there any deterioration of cardiac or neurologic symptoms in the meantime? In conclusion, more data about cardiac and neurologic findings would be useful to increase our knowledge about cardiac involvement in patients with myopathies and to improve the care for them.