## 1 Introduction
Table 1 presents an overview of various authors' research over different periods. Each study included a distinct number of participants (\(n\)) and used different techniques to measure strain with different modalities providing detailed measurements. DMD is a rare and severe genetic disorder marked by muscle degeneration and weakness, impacting both skeletal and cardiac muscles [25]. It is caused by a mutation in the gene encoding the dystrophin protein, and it stands as the most prevalent and severe form of muscular dystrophy, impacting 1 (one) in every 5000 male births globally [26]. The early detection of cardiac complications in DMD remains a significant challenge [27]. For example, [PERSON] et al. [19] hypothesized that the global circumferential strain (GCS) of the left ventricle (LV) would decrease in DMD before the onset of clinical symptoms. They evaluated CMR imaging in a cohort comprising 17 DMD patients and 16 healthy controls. They analyzed the tagged images with the HARmonic Phase technique for the myocardial strain measurements. Additionally, the research work of [PERSON] et al. [20] investigated the role of STE in detecting the earliest signs of impaired cardiac function in DMD patients. For instance, [PERSON] et al. [21] conducted a study using CMR-FT and STE techniques in DMD patients and aged-matched controls to measure the strain. In 2020, the research of [PERSON] et al. [22] examined echocardiographic and clinical data. The researchers demonstrated that the global longitudinal strain (GLS) was noticeably impairedin apical segments and the posterolateral wall, while there was a notable decrease in the GCS observed specifically in the anteroseptal, anterior, and anterolateral segments in older patients. Then, [PERSON] et al. [23] conducted a study employing CMR strain analysis and mitral annular plane systolic excursion (MAPSE) to detect the earliest LV dysfunction in DMD patients. This study evaluated three categories of patients: the first category included patients with gadolinium enhancement (LGE) and left ventricle ejection fraction (LVEF) < 50%, the second category was patients with LGE and LVEF \(\geq\) 50%, and the last category patients without LGE and LVEF \(\geq\) 50%. The first and second categories had significantly lower GCS, GLS, global radial strain (GRS) values, and MAPSE than controls. This research has highlighted significant advances, proving that MAPSE and FT measurements allow precise evaluation of early cardiac impairment in DMD patients. A recent study by [PERSON] et al. [24] compared CMR imaging with transthoracic echocardiography (TTE), incorporating tissue Doppler imaging (TDI) and speckle tracking echocardiography for the early diagnosis of cardiomyopathy in DMD patients. These studies [19; 20; 21; 22; 23; 24] have shown that the CMR imaging technique provides significant results for DMD diagnosis compared with the STE technique. Nevertheless, these results can still be improved, as research on myocardial strain in pediatric populations remains limited. Hence, this research work aimed to expand the use of CMR-FT to evaluate global circumferential, longitudinal, and radial strain of the LV, as well as segmental strain at two specific levels, anterolateral and inferolateral, in DMD patients, and to compare these measurements with those of age-matched healthy controls. The main contributions of the current research are the following. * A dataset was collected for this study that comprised data of 28 DMD patients and 20 healthy controls. * Exploration of the utility of myocardial strain measurements: This study is among the first to explore the utility of cardiac magnetic resonance-feature tracking (CMR-FT) for early diagnosis of Duchenne muscular dystrophy (DMD) in pediatric patients, a population where early detection is crucial for timely intervention. * Our research highlights the use of CMR-FT in detecting myocardial strain abnormalities in DMD patients without relying on late gadolinium enhancement (LGE).