Analyses of Left Ventricular Myocardial Deformation by Speckle-Tracking Imaging During the Acute Phase of Kawasaki Disease

Abstract

This study aimed to investigate left ventricular myocardial deformation in children with Kawasaki disease during the acute phase of their illness. A total of 50 patients and 35 normal control subjects were assessed. Data were obtained from the patients during the acute and convalescent phases of Kawasaki disease. Analyses of myocardial deformation [strain (epsilon), strain rate (SR)] was performed using two-dimensional speckle-tracking imaging in three directions (longitudinal, circumferential, and radial) at the basal and mid levels of the left ventricular myocardium. Basal longitudinal epsilon (P < 0.001) and midlongitudinal epsilon (P < 0.0001) were lower during the acute phase of the disease than in the control subjects and associated with serum albumin level and left ventricular mass index (LVMI). Midlongitudinal SR (P < 0.0001) was lower during the acute phase of Kawasaki disease than in the control subjects and associated with LVMI. Decreased systolic SR was not detected in any direction. In conclusion, left ventricular longitudinal systolic epsilon was significantly decreased during the acute phase of Kawasaki disease. This may be a result of myocardial swelling from myocarditis during the acute phase of the disease.

Reference Ranges of Left Ventricular Strain Measures by Two-Dimensional Speckle-Tracking Echocardiography in Children: A Systematic Review and Meta-Analysis

“…LV free wall from the apical 4- chamber views was reported in 9 of 43 data sets ( n=716 children). 7,8,16,17,28-30,34,36 The normal mean values of FW SL varied from -17.00% to -23.4 % (mean -20.2%, 95% CI -19.2% to -22.2%). Between-study heterogeneity was evidenced by a Cochran's Q statistic of 458 (P < 0.0001) and inconsistency by an I 2 value of 96.3%.…”

“…11,15,16,19,20,23,25,26,28,29,33,41-43,46 The patient characteristics of the included studies are listed in Table 1. The echocardiographic variables included from the studies are listed in Table 2.…”

“…7,8,10-13,16-19,21,22,28-34,36-38,40,42,43,48 (There were four datasets that reported both the GLS and the LS from the apical 4-chamber view only. 19,28,30,33 ) The normal mean values of LS varied from -15.1% to -24.8% (mean -20.4, 95% CI -19.8% to -21.7%), (Figure 2b).…”

Aging change of left ventricular function in children evaluated by acoustic quantification method

“…Of 30 cases with history of Kawasaki disease, 5 had decreased ejection fraction during acute phase. There have been some reports about left ventricular dysfunction during the acute phase of Kawasaki disease [18][19][20]. However, more than 1 year had passed since the patients had contracted Kawasaki disease, and there was no influence of myocarditis during the acute phase.…”

Estudio de la función miocárdica mediante ecocardiografía con Speckle-Tracking valores normales en una población pediátrica

“…En el infarto de miocardio se encontraron disminuidos los valores de strain global y además se notó que los valores de deformación miocárdica se mantuvieron normales en los segmentos no relacionados con la necrosis. 27 En pediatría se han publicado estudios en la enfermedad de Kawasaki 28,29 en los que se encontró la deformación miocárdica longitudinal (figura 6) disminuida con respecto al grupo control y se observó además que esta alteración se hallaba relacionada con los niveles de albúmina sérica y de la masa miocár-dica del ventrículo izquierdo aumentados por la trasudación inflamatoria de la miocarditis que ocurre en la fase aguda de esta enfermedad.…”