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Assessment of left ventricular function in Kawasaki disease by dipyridamole-loading cineventriculography
Insights
Dipyridamole-loading cineventriculography effectively evaluates left ventricular (LV) function in Kawasaki disease patients. Abnormal LV wall motion after dipyridamole infusion indicates cardiac involvement, aiding diagnosis.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Diagnostic Imaging
Background:
- Kawasaki disease frequently causes coronary artery abnormalities.
- Left ventricular (LV) dysfunction can be a complication of Kawasaki disease.
- Assessing LV function is crucial for managing Kawasaki disease patients.
Purpose of the Study:
- To evaluate left ventricular (LV) function using dipyridamole-loading cineventriculography in patients with Kawasaki disease.
- To determine the utility of dipyridamole-induced LV wall motion analysis in detecting cardiac involvement.
Main Methods:
- Dipyridamole-loading cineventriculography was performed on 76 patients with Kawasaki disease.
- Patients were categorized into groups based on the timing of the procedure and coronary lesion severity.
- Global LV ejection fraction and regional LV wall motion were analyzed before and after dipyridamole infusion.
Main Results:
- Global LV ejection fraction increased with dipyridamole in patients with normal or mild coronary lesions.
- Abnormal regional LV wall motion was detected in a significant percentage of patients with moderate to severe coronary lesions after dipyridamole administration.
- The incidence of abnormal LV wall motion after dipyridamole was higher in patients with more severe coronary artery disease.
Conclusions:
- Dipyridamole-loading cineventriculography is a valuable tool for assessing LV function in Kawasaki disease.
- Analysis of LV wall motion changes induced by dipyridamole can help identify cardiac involvement.
- This technique aids in the comprehensive evaluation of cardiovascular complications in Kawasaki disease.
Abstract:
Dipyridamole-loading cineventriculography was performed to evaluate left ventricular (LV) function in 76 patients with Kawasaki disease. Forty-five of 76 patients underwent the procedure within 6 months from the onset of illness (group 1A, normal findings on coronary angiogram; group 1B, maximal diameter of coronary lesions less than 4 mm; group 1C, maximal diameter of coronary lesions greater than 4 mm). Thirty-one of 76 patients underwent the procedure greater than 6 months after onset (group 2A, coronary lesions improved to normal or less than 4 mm; group 2B, remaining coronary lesions greater than 4 mm; group 2C, stenosis or obstruction of the coronary artery). Global LV ejection fraction increased in groups 1A, 1B and 2A after infusion of dipyridamole, but there was no significant change in groups 1C, 2B and 2C. In analyzing LV excursion, the pattern of LV wall motion with dipyridamole in groups 1B and 2A were similar to that in group 1A, but in 38% (5 of 13) of group 2A patients, abnormal regional LV wall motion after administration of dipyridamole was detected. Abnormal LV wall motion after dipyridamole infusion was detected in 42% (5 of 12) of group 1C patients, 38% (3 of 8 cases) of group 2B patients and 70% (7 of 10 cases) of group 2C patients. In conclusion, analysis of LV wall motion with dipyridamole is useful in evaluating cardiac involvement in Kawasaki disease.