CMR Evaluation of Cardiac Involvement During the Convalescence of Kawasaki Disease

Mavrogeni, Sophie; Bratis, Konstantinos; Karanasios, Evangelos; Georgakopoulos, Dimitrios G.; Kaklis, Savas; Varlamis, George; Kolovou, Genovefa; Douskou, Marouso; Papadopoulos, George

doi:10.1016/j.jcmg.2011.04.021

Cited by 23 publications

(17 citation statements)

References 4 publications

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“…However, a comparison with normal values was not reported, and although patients were reported to be reevaluated after 3 months, functional follow-up data were not described. 28 Several investigators have reported mean normal values for CMRI indexes in healthy subjects, but these studies overall reported lower biventricular EDV and ESV and higher EF than we found in the present study (Table 3). [33][34][35][36][37][38][39][40][41] The differences may be explained by the age range of the study population, the use of different CMRI techniques, and the use of different image analysis protocols.…”

Section: Discussioncontrasting

confidence: 70%

“…Another and more likely explanation is that-in contrast to large areas of myocardium affected by ischemic processesthe prior myocarditis-related damage cannot be detected on CMRI because of its diffuse and limited nature. This is supported by a recent study by Mavrogeni et al 28 CMRIs were performed in 13 patients during the reconvalescence of KD (20-40 days after the onset of disease). Both early enhancement and T2-weighted analysis were highly suggestive of an active inflammatory process in 6 of 13 patients (46%).…”

Section: Discussionsupporting

confidence: 68%

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Evaluation of Cardiac Function by Magnetic Resonance Imaging During the Follow-Up of Patients With Kawasaki Disease

Tacke

Romeih

Kuipers

et al. 2013

Circ: Cardiovascular Imaging

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Background-Although histopathologic studies suggest persistent myocardial abnormalities after Kawasaki disease (KD), the long-term effects on cardiac function remain to be revealed. We investigated biventricular volumes, function, and the presence of myocardial fibrosis by cardiac magnetic resonance imaging during long-term follow-up of KD. Methods and Results-Sixty patients with a history of KD (mean age, 16.9 years; 67% men; median interval after KD onset, 11.6 years) and 20 healthy control subjects (mean age, 17.9 years; 55% men) 12 to 24 years of age underwent cardiac magnetic resonance imaging. Biventricular end-diastolic volume, end-systolic volume, stroke volume, and ejection fraction were determined. Volumetric measurements were indexed for body surface area. Late contrast enhancement was used to detect areas of myocardial fibrosis. Biventricular volumes and function did not differ significantly between patients and control subjects. There were also no significant differences between patients with and without a history of left ventricular dysfunction resulting from KD-associated myocarditis or between patients with and without coronary artery aneurysms.Only those with prior ischemic heart disease had a significantly lower left ventricular ejection fraction compared with unaffected KD cases (left ventricular ejection fraction, 51% versus 57%; P=0.012). Late contrast enhancement was observed in only 2 patients with severe coronary artery aneurysms and was typical for myocardial infarction. Conclusions-In this cardiac magnetic resonance imaging study evaluating the cardiac function of patients with KD at longterm follow-up, we did not observe a difference in cardiac function between KD patients and control subjects, except for a subgroup of patients with ischemic heart disease as a result of severe coronary artery pathology.

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionsupporting

confidence: 68%

Evaluation of Cardiac Function by Magnetic Resonance Imaging During the Follow-Up of Patients With Kawasaki Disease

Tacke

Romeih

Kuipers

et al. 2013

Circ: Cardiovascular Imaging

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“…[23] Novel CMR techniques, such as T1 mapping quantification, could potentially offer more thorough appreciation of possible prior myocarditis-related damage with diffuse and limited nature and its correlation to CMR-FT abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Cardiac magnetic resonance feature tracking in Kawasaki disease convalescence

Bratis

Hachmann

Child

et al. 2017

Annals of Pediatric Cardiology

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Objective:The objective of this study was to determine whether left ventricular (LV) myocardial deformation indices can detect subclinical abnormalities in Kawasaki disease convalescence. We hypothesized that subclinical myocardial abnormalities due to inflammation represent an early manifestation of the disease that persists in convalescence.Background:Myocardial inflammation has been described as a global finding in the acute phase of Kawasaki disease. Despite normal systolic function by routine functional measurements, reduced longitudinal strain and strain rate have been detected by echocardiography in the acute phase.Methods and Results:Peak systolic LV myocardial longitudinal, radial, and circumferential strain and strain rate were examined in 29 Kawasaki disease convalescent patients (15 males; mean [standard deviation] age: 11 [6.6] years; median interval from disease onset: 5.8 [5.4] years) and 10 healthy volunteers (5 males; mean age: 14 [3.8] years) with the use of cardiac magnetic resonance (CMR) feature tracking. Routine indices of LV systolic function were normal in both groups. Comparisons were made between normal controls and (i) the entire Kawasaki disease group, (ii) Kawasaki disease subgroup divided by coronary artery involvement. Average longitudinal and circumferential strain at all levels was lower in patients compared to normal controls. In subgroup analysis, both Kawasaki disease patients with and without a history of coronary involvement had similar longitudinal and circumferential strain at all levels and lower when compared to controls. There were lower circumferential and longitudinal values in Kawasaki disease patients with persisting coronary artery lesions when compared to those with regressed ones.Conclusion:In this CMR study in Kawasaki disease convalescent patients with preserved routine functional indices, we detected lower circumferential and longitudinal strain values compared to normal controls, irrespective of the coronary artery status.

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“…7). Conventional digital subtraction coronary angiography is used in challenging cases where an invasive procedure is required [23,24].…”

Section: Kawasaki Diseasementioning

confidence: 99%

Imaging of systemic vasculitis in childhood

et al. 2015

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The term "systemic vasculitis" encompasses a diverse set of diseases linked by the presence of blood-vessel inflammation that are often associated with critical complications. These diseases are uncommon in childhood and are frequently subjected to a delayed diagnosis. Although the diagnosis and treatment may be similar for adult and childhood systemic vasculitides, the prevalence and classification vary according to the age group under investigation. For example, Kawasaki disease affects children while it is rarely encountered in adults. In 2006, the European League Against Rheumatism (EULAR) and the Pediatric Rheumatology European Society (PReS) proposed a classification system for childhood vasculitis adopting the system devised in the Chapel Hill Consensus Conference in 1993, which categorizes vasculitides according to the predominant size of the involved blood vessels into small, medium and large vessel diseases. Currently, medical imaging has a pivotal role in the diagnosis of vasculitis given recent developments in the imaging of blood vessels. For example, early diagnosis of coronary artery aneurysms, a serious complication of Kawasaki disease, is now possible by magnetic resonance imaging (MRI) of the heart and multidetector computed tomography (MDCT); positron emission tomography/CT (PET/CT) helps to assess active vascular inflammation in Takayasu arteritis. Our review offers a unique approach using the integration of the proposed classification criteria for common systemic childhood vasculitides with their most frequent imaging findings, along with differential diagnoses and an algorithm for diagnosis based on common findings. It should help radiologists and clinicians reach an early diagnosis, therefore facilitating the ultimate goal of proper management of affected children.

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CMR Evaluation of Cardiac Involvement During the Convalescence of Kawasaki Disease

Cited by 23 publications

References 4 publications

Evaluation of Cardiac Function by Magnetic Resonance Imaging During the Follow-Up of Patients With Kawasaki Disease

Evaluation of Cardiac Function by Magnetic Resonance Imaging During the Follow-Up of Patients With Kawasaki Disease

Cardiac magnetic resonance feature tracking in Kawasaki disease convalescence

Imaging of systemic vasculitis in childhood

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