Noninvasive Evaluation of Myocardial Systolic Dysfunction in the Early Stage of Kawasaki Disease: A Speckle-Tracking Echocardiography Study

Abstract

Background:Evaluation of myocardial function by speckle-tracking echocardiography is a new method for the early diagnosis of systolic dysfunction.Objectives:We aimed to determine myocardial speckle-tracking echocardiography indices in Kawasaki Disease (KD) patients and compare them with the same indices in control subjects.Patients and Methods:Thirty-two patients (65.5% males) with KD and 19 control subjects with normal echocardiography participated in this study. After their demographic characteristics and clinical findings were recorded, all the participants underwent transthoracic echocardiography. Strain (S), Strain Rate (SR), Time to Peak Strain (TPS), and Strain Rate (TPSR), longitudinal velocity and view point velocity images in the two, three, and four-chamber views were semi-automatically obtained via speckle-tracking echocardiography.Results:Among the patients, Twenty-four cases (75%) were younger than 4 years. Mean global S and SR was significantly reduced in the KD patients compared to controls (17.03 ± 1.28 vs. 20.22 ± 2.14% and 1.66 ± 0.16 vs. 1.97 ± 0.25 1/second, respectively), while there were no significant differences regarding mean TPS, TPSR, longitudinal velocity and view point velocity. Using repeated measure of analysis of variances, we observed that S and SR decreased from base to apical level in both groups. The change in the pattern of age adjusted mean S and SR across levels was significantly different between the groups (P < 0.001 for both parameters).Conclusions:We showed changes in S and SR assessed in KD patients versus control subjects in the acute phase of KD. However, we suggest that further studies be undertaken to compare S and SR in the acute phase and thereafter in KD patients.

Global Myocardial Strain in Multisystem Inflammatory Syndrome in Children, Kawasaki Disease, and Healthy Children: A Network Meta-Analysis

“…Kawasaki disease is a well-known, self-limited, systemic inflammatory vasculitis that mainly affects small-and mediumsized arteries. Several previous studies confirmed impaired left ventricular myocardial strain of KD in the acute phase using STE (20,22) or velocity vector imaging (25,26). Our results found that KD had impaired GLS and GCS in the acute phase compared with the healthy children, consistent with those published articles (20,22,25,26).…”

“…Several previous studies confirmed impaired left ventricular myocardial strain of KD in the acute phase using STE (20,22) or velocity vector imaging (25,26). Our results found that KD had impaired GLS and GCS in the acute phase compared with the healthy children, consistent with those published articles (20,22,25,26). The progressive structural alterations of the myocardium and coronary arteries were confirmed during the convalescent phase of KD in the previous studies (27)(28)(29).…”

The Assessment of Myocardial Strain by Cardiac Imaging in Healthy Infants with Acute Bronchiolitis: A Systematic Review and Meta-Analysis

“…Ventricular strain and torsion analysis by STE consist of capturing and tracking points of the two-dimensional echocardiogram throughout the cardiac cycle, generating movement vectors and strain. It has provided additional insight into the changes in systolic function in patients with PH by showing significant reductions in systolic torsion as well as LS and CS [49][50][51][52]. Thus, reliable, quantitative measures of ventricular performance may aid in the detection of MS in AB and to establish a better understanding of disease severity.…”

Assessing left ventricular systolic function in children with a history of Kawasaki disease

“…The LV ejection fraction (LVEF) is the most commonly used conventional parameter to quantify global LV systolic function in children with KD; however, previous studies have usually demonstrated normal LVEF in the acute phase [5,6]. Speckle tracking echocardiography (STE) has recently been shown to be a reliable method with which to assess LV systolic function and deformation through LV myocardial strain [7][8][9].…”

“…Although myocardial function and coronary artery diameter in most patients have recovered after treatment [6,8], there is evidence of ongoing myocardial and coronary arterial structural alterations in the long-term [11][12][13]. Few studies have focused on LV myocardial strain of children with a history of KD after long-term follow-up using STE, especially children with KD but without CAD [7][8][9]. Excluding coronary artery aneurysms, whether or not there is a long-term effect of CAD on LV myocardial strain is unclear.…”