Cardiac magnetic resonance feature tracking of the right ventricle in convalescent Kawasaki disease in a large single center

Abstract

BackgroundThe changes in right ventricular (RV) contractility of Kawasaki disease (KD) still remain unclear.HypothesisWe aimed to determine whether RV systolic dysfunction can be detected by cardiac magnetic resonance (CMR) feature tracking and to find its association with coronary artery lesions (aneurysm, thrombosis and stenosis).MethodsPeak systolic myocardial longitudinal, radial and circumferential strain and the strain rate (RVSL, RVSR, RVSC, RVSRL, RVSRR and RVSRC) in the global RV and three levels (basal, middle and apical) were measured in 66 patients with convalescent KD. A total of 20 controls were included. Comparisons were made with controls and among KD subgroups divided with coronary artery lesions.ResultsRVSC (−10.575% vs. −10.760%), RVSL (−18.150% vs. −18.712%) and RVSRC (−0.815/s vs. −0.924/s) were slightly lower in KD group without significant difference. All the strain and strain rate presented lowest in the basal level. In subgroup comparison, lower RVSL and RVSRL were observed in the giant coronary artery aneurysm (CAA) group; RVSR (15.844% vs. 16.897%), RVSRR (1.245/s vs. 1.322/s) and RVSRC (−0.715/s vs. −0.895/s) were lower in thrombosed group; RVSRL (−1.27/s vs. −1.503/s) were lower in stenosis group. All the comparison in subgroups did not reach significant difference. From the analysis of receiver operating characteristic curve, RVSRL had a better ability to identify KD with giant CAA and stenosis. For the identification of thrombosis, RVSRC had a better ability.ConclusionsLower strain and strain rates of RV were detected in convalescent KD. More pronounced in those with persisting coronary artery lesions.

Reproducibility and its confounders of CMR feature tracking myocardial strain analysis in patients with suspected myocarditis

“…RV strain is increasingly incorporated as a marker of RV diagnostics [21,22]. Generally, studies with samples of under 20 controls or patients investigating RV reproducibility have shown fair results for free wall peak strain and diastolic strain rate [8,[22][23][24]. With a sample of 125 patients, we observed good reliability for RV peak strain and diastolic strain rate, demonstrating both systolic and diastolic functions of the RV can be reliably measured in a patient population.…”

“…RV strain is increasingly incorporated as a marker of RV diagnostics [21,22]. Generally, studies with samples of under 20 controls or patients investigating RV reproducibility have shown fair results for free wall peak strain and diastolic strain rate [8,[22][23][24].…”

Quantification of Myocardial Deformation Applying CMR-Feature-Tracking—All About the Left Ventricle?

“…For example, subtle attenuations of LV and RV longitudinal function were found in patients with Marfan syndrome, while RV GCS values were increased reflecting a potential compensation mechanism and indicating the existence of a Marfan-related cardiomyopathy that is detectable by applying CMR-FT deformation analyses [90]. Furthermore, CMR-FT detected lower RV strain in patients with convalescent Kawasaki disease and RV functional impairment was more pronounced in those with persisting coronary artery lesion [91]. Another study showed high iron deposition in the myocardium to be detectable including CMR-FT-derived RV deformation and therefore timely modification and chelation therapy may be navigated by this non-invasive imaging approach [92].…”