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Comment & Response
September 2017

Myocardial Fibrosis in Duchenne and Becker Muscular Dystrophy—Reply

Author Affiliations
  • 1Cardiovascular Magnetic Resonance Sector, Heart Institute, InCor, University of São Paulo Medical School, São Paulo, Brazil
JAMA Cardiol. 2017;2(9):1046. doi:10.1001/jamacardio.2017.1048

In Reply We are glad to have this opportunity to respond to the letter by Bahler. We appreciate his interest in our study published in JAMA Cardiology1 and thank him for his thoughtful comments on our work.

We agree with him that we have approached a very important clinical question in our article, which is the early initiation of angiotensin-converting enzyme (ACE) inhibitor therapy in patients with muscular dystrophy with myocardial fibrosis (MF) but preserved left ventricular (LV) function. We also agree that after demonstrating that MF progression can be altered by early ACE inhibitor therapy, the next step would be to investigate whether this finding could be translated into better clinical outcomes through larger randomized trials.

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