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Updated: Jan 23, 2026

Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation

Published on: October 20, 2016

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Evaluation of left ventricular function in immunoglobulin-resistant children with Kawasaki disease: a two-dimensional

Haiyong Wang1, Jing Shang1, Minghui Tong2

  • 1Department of Ultrasound Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.

Clinical Cardiology
|June 8, 2019
PubMed

Insights

Intravenous immune globulin (IVIG)-resistant Kawasaki disease patients show reduced left ventricular (LV) systolic function. Two-dimensional speckle tracking echocardiography (STE) can identify these patients, aiding in early risk stratification for IVIG resistance.

Area of Science:

  • Pediatric Cardiology
  • Echocardiography
  • Cardiovascular Research

Background:

  • Kawasaki disease (KD) patients unresponsive to intravenous immune globulin (IVIG) often develop coronary artery lesions (CALs).
  • Left ventricular (LV) function changes in IVIG-resistant KD are not well understood.
  • Early identification of IVIG resistance is crucial for timely intervention.

Purpose of the Study:

  • To evaluate the utility of two-dimensional speckle tracking echocardiography (STE) in assessing LV systolic function in IVIG-resistant KD patients.
  • To identify STE parameters that can predict IVIG resistance in KD.
  • To differentiate IVIG-resistant KD patients who may have subclinical myocardial dysfunction.

Main Methods:

  • A study involving 50 IVIG-resistant KD patients, 50 IVIG-responsive KD patients, and 50 healthy controls.
  • Analysis of LV global longitudinal strain (GLS) and global circumferential strain (GCS) using STE.
  • Receiver operating characteristic (ROC) curve analysis to determine optimal thresholds for predicting IVIG resistance.

Main Results:

  • IVIG-resistant patients exhibited significantly lower GLS and GCS compared to both normal subjects and IVIG-responsive patients.
  • Absolute GLS values < 16.8% and GCS values < 15.9% were identified as optimal predictors of IVIG unresponsiveness.
  • ROC analysis showed area under the curve values of 0.78 for GLS and 0.75 for GCS, with high sensitivity and specificity.

Conclusions:

  • IVIG-resistant KD patients present with more pronounced LV systolic dysfunction, potentially due to myocarditis.
  • STE is a valuable tool for detecting subclinical myocardial dysfunction in KD.
  • STE parameters can serve as supportive criteria for identifying KD patients at higher risk of IVIG resistance.
Abstract

Keywords:
Kawasaki diseaseintravenous immune globulin resistanceleft ventricular functiontwo-dimensional speckle tracking echocardiography

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