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Updated: Mar 27, 2026
Ultrasonic Assessment of Myocardial Microstructure
Published on: January 14, 2014
Quantitative evaluation of myocardial fibrosis by cardiac integrated backscatter analysis in Kawasaki disease
Lijian Xie1, Renjian Wang2, Min Huang2
1Department of Cardiology, Shanghai Children's Hospital, Shanghai Jiaotong University, No. 355 Luding Road, Shanghai, 200062, China. naijileix@aliyun.com.
Insights
Myocardial fibrosis is present in Kawasaki disease (KD) patients, even in early stages. Cardiac integrated backscatter imaging quantifies this fibrosis, which correlates with coronary artery status in KD.
Area of Science:
- Cardiology
- Pediatric Rheumatology
- Medical Imaging
Background:
- Kawasaki disease (KD) is an acute systemic vasculitis affecting coronary arteries.
- The presence and extent of myocardial fibrosis in KD have not been previously quantified.
- This study investigates myocardial fibrosis in KD patients using cardiac integrated backscatter (CIB).
Purpose of the Study:
- To quantitatively assess myocardial fibrosis in Han Chinese patients with Kawasaki disease.
- To explore the relationship between myocardial fibrosis and the coronary artery status in KD patients.
- To evaluate the utility of cardiac integrated backscatter (CIB) imaging for detecting myocardial fibrosis in KD.
Main Methods:
- Ninety KD patients and 90 healthy controls were enrolled.
- KD patients were categorized by disease phase (acute, subacute, convalescence) and coronary artery status (none, dilation, aneurysms).
- Myocardial fibrosis was assessed using calibrated integrated backscatter (CIBS) imaging via echocardiography.
Main Results:
- Left ventricular systolic function was normal in all participants.
- CIBS values, indicating myocardial fibrosis, were significantly elevated in all KD phases compared to controls (p < 0.001).
- Higher CIBS values correlated with more severe coronary artery lesions (dilation, aneurysms) and were positively correlated with coronary artery status across all KD phases (r = 0.331–0.456, p < 0.001).
Conclusions:
- Myocardial fibrosis is detectable and quantifiable in Kawasaki disease patients, even in early stages.
- The degree of myocardial fibrosis correlates with the severity of coronary artery involvement in KD.
- Cardiac integrated backscatter imaging is a valuable tool for assessing myocardial fibrosis in Kawasaki disease.
Background:
Kawasaki disease is an acute, systemic vasculitis that affects the coronary arteries. However, the relationship between myocardial fibrosis and Kawasaki disease has been completely unknown until now. We aimed to provide quantitative information about myocardial fibrosis using cardiac integrated backscatter in Han race Kawasaki disease patients.
Methods:
Ninety Kawasaki disease patients and 90 healthy control subjects were recruited. Based on Kawasaki disease status, the patients were categorized into 3 groups: acute, subacute, and convalescence phase. Based on coronary artery status, the Kawasaki disease patients were categorized into 3 groups: without coronary artery lesions, with coronary artery dilation, and with coronary artery aneurysms. All subjects underwent two-dimensional and Doppler examinations to measure clinical echocardiographic parameters. Myocardial fibrosis was detected with calibrated integrated backscatter imaging.
Results:
Left ventricle systolic functions were normal in both the Kawasaki disease and control participants. The myocardial calibrated integrated backscatter values of the left ventricles of the acute (p < 0.001), subacute (p < 0.001) and convalescence phase (p < 0.001) Kawasaki disease patients were significantly greater than those of the healthy controls. The left ventricle myocardial calibrated integrated backscatter values were significantly smaller in the Kawasaki disease patients without coronary artery lesions than in the Kawasaki disease patients with coronary artery dilations and coronary artery aneurysms in different phases. The left ventricle myocardial calibrated integrated backscatter results were positively correlated with coronary artery status in the acute (r = 0.331, p < 0.001), subacute (r = 0.456, p < 0.001) and convalescence phases (r = 0.407, p < 0.001) of Kawasaki disease.
Conclusion:
Our findings may suggest that myocardial fibrosis occurs during early episodes of Kawasaki disease given uncertainties that exist regarding correlations of calibrated integrated backscatter and myocardial fibrosis.
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