Comprehensive left ventricular myocardial deformation assessment in children with Kawasaki disease

Sanchez, Aura A.; Tejtel, S. Kristen Sexson; Almeida-Jones, Myriam; Feagin, Douglas K.; Altman, Carolyn A.; Pignatelli, Ricardo H.

doi:10.1111/chd.12787

Cited by 9 publications

(7 citation statements)

References 30 publications

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“…In agreement with these studies 10 , 11 , we have confirmed a reduction of global longitudinal strain even if not statistical significant, in a sample of 45 children with established diagnosis of KD complicated by coronary dilatation when compared to CTRLs and also in group of ten children with KD in absence of coronary aneurysms.…”

Section: Discussionsupporting

confidence: 89%

“…Moreover, Sanchez et al 11 have recently demonstrated that children in the convalescent/chronic phase of KD (n = 67) are characterized by a subtle reduction in strain rate compared to the acute phase, that it is more pronounced in patients with coronary aneurysm than in those without.…”

Section: Discussionmentioning

confidence: 99%

“…Speckle tracking echocardiography (STE) has previously identified patients with coronary disease with good sensitivity 9 . Moreover, recent studies have demonstrated abnormal strain in patients with KD, despite normal left ventricular ejection fraction 10 , 11 .…”

Section: Introductionmentioning

confidence: 99%

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Abnormal myocardial work in children with Kawasaki disease

Sabatino

Borrelli

Fraisse

et al. 2021

Sci Rep

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Kawasaki disease (KD) can be associated with high morbidity and mortality due to coronary artery aneurysms formation and myocardial dysfunction. Aim of this study was to evaluate the diagnostic performance of non-invasive myocardial work in predicting subtle myocardial abnormalities in Kawasaki disease (KD) children with coronary dilatation (CADL). A total of 100 patients (age 8.7 ± 5 years) were included: 45 children with KD and CADL (KD/CADL) (Z-score > 2.5), 45 age-matched controls (CTRL) and, finally, an additional group of 10 children with KD in absence of coronary dilatation (KD group). Left ventricular (LV) systolic function and global longitudinal strain (GLS) were assessed. Global myocardial work index (MWI) was calculated as the area of the LV pressure-strain loops. From MWI, global Constructive Work (MCW), Wasted Work (MWW) and Work Efficiency (MWE) were estimated. Despite normal LV systolic function by routine echocardiography, KD/CADL patients had lower MWI (1433.2 ± 375.8 mmHg% vs 1752.2 ± 265.7 mmHg%, p < 0.001), MCW (1885.5 ± 384.2 mmHg% vs 2175.9 ± 292.4 mmHg%, p = 0.001) and MWE (994.0 ± 4.8% vs 95.9 ± 2.0%, p = 0.030) compared to CTRL. Furthermore, MWI was significantly reduced in children belonging to the KD group in comparison with controls (KD: 1498.3 ± 361.7 mmHg%; KD vs CTRL p = 0.028) and was comparable between KD/CADL and KD groups (KD/CADL vs KD p = 0.896). Moreover, KD/CADL patients with normal GLS (n = 38) preserved significant differences in MWI and MCW in comparison with CTRL. MWI, MCW and MWE were significantly reduced in KD children despite normal LVEF and normal GLS. These abnormalities seems independent from CADL. Thus, in KD with normal LVEF and normal GLS, estimation of MWI may be a more sensitive indicator of myocardial dysfunction.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Abnormal myocardial work in children with Kawasaki disease

Sabatino

Borrelli

Fraisse

et al. 2021

Sci Rep

View full text Add to dashboard Cite

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“…In KD, decreased ventricular contractility may be caused by the combination of myocardial inflammation, microvascular injury, and complications of CALs (16). For patients with CAAs, the myocardial deformation was more obvious (17) and could be improved after treatment and in regressed CAAs (7). Our research showed impaired contractility in segments supplied by severe CAA, and this was associated with thrombosis.…”

Section: Intra-observer and Inter-observer Agreementmentioning

confidence: 57%

Evaluation of comprehensive myocardial contractility in children with Kawasaki disease by cardiac magnetic resonance in a large single center

Yao¹,

Hu²,

He³

2022

Quant Imaging Med Surg

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Background: Children with Kawasaki disease (KD) and coronary artery lesions (CALs) can develop myocardial ischemia, fibrosis, and abnormal contractility. We aimed to assess the association between myocardial mechanical deformation with myocardial fibrosis, ischemia, and CALs.Methods: In total, 76 KD and 20 healthy volunteers received cardiac magnetic resonance (CMR). Peak systolic left ventricular (LV) longitudinal, radial, and circumferential strain and strain rate [LV strain longitudinal (LVSL), LV strain radial (LVSR), LV strain circumferential (LVSC), LV strain rate longitudinal (LVSRL), LV strain rate radial (LVSRR), and LV strain rate circumferential (LVSRC)], along with late gadolinium enhancement (LGE), perfusion deficit, and CALs in related segments were analyzed. The KD group was subdivided by CALs, perfusion, and LGE results, and strain results were compared with controls and in subgroups.Results: Cardiac fibrosis and ischemia were not confined to the territory of CALs. In a global analysis, strain and strain rates were lower in the KD group, especially in the subgroup with LGE and perfusion deficit. In segmental analysis, LVSR, LVSC, LVSL, and LVSRR decreased in the giant aneurysm group, and a lower LVSR (20.369%±10.603% vs. 26.071%±12.349%) and LVSC (-13.37%±5.365% vs.-15.847%±5.778%) were observed in thrombosed segments. The strain and strain rate were all lower in segments with LGE and perfusion deficit, and no obvious difference was found between groups with and without stenosis. LVSR had a better ability to identify giant aneurysm, thrombosis, stenosis, perfusion deficit, and LGE. Conclusions:We detected lower strain values in KD patients, which was more pronounced in segments with aneurysm, thrombi, LGE, and perfusion deficit. LVSR is useful to discern patients with higher risk.

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“…For KD, the routine cardiac function often displays normal with routine measurements, 1 except for patients with ischemic cardiomyopathy and severe CALs 2‐4 . However, lower strain has both been detected in the acute and convalescent phase of KD 5‐7 . The strain and strain rate are the main indices in the paper.…”

Section: Introductionmentioning

confidence: 96%

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

Yao

2020

Clinical Cardiology

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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.

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Comprehensive left ventricular myocardial deformation assessment in children with Kawasaki disease

Cited by 9 publications

References 30 publications

Abnormal myocardial work in children with Kawasaki disease

Abnormal myocardial work in children with Kawasaki disease

Evaluation of comprehensive myocardial contractility in children with Kawasaki disease by cardiac magnetic resonance in a large single center

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

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