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Cardiac Function by Magnetic Resonance Imaging in Coronary Artery Occlusions After Kawasaki Disease

Hideyuki Nakaoka1, Etsuko Tsuda1, Yoshiaki Morita2

  • 1Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center.

Circulation Journal : Official Journal of the Japanese Circulation Society
|April 3, 2020
PubMed

Insights

Patients with asymptomatic coronary artery occlusion (ACAO) after Kawasaki disease (KD) typically maintain preserved left ventricular (LV) function. Significant LV dysfunction is linked to extensive late gadolinium enhancement (LGE) exceeding 50%.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Cardiovascular Imaging

Background:

  • Kawasaki disease (KD) can lead to coronary artery abnormalities.
  • Asymptomatic coronary artery occlusion (ACAO) is a potential long-term complication of KD.
  • Ventricular function in ACAO patients post-KD requires clarification.

Purpose of the Study:

  • To assess left ventricular (LV) function in patients with ACAO following Kawasaki disease.
  • To investigate the relationship between the extent of late gadolinium enhancement (LGE) and LV ejection fraction (EF) in these patients.

Main Methods:

  • Cardiac magnetic resonance (CMR) imaging was performed on 65 patients with coronary artery lesions post-KD.
  • Late gadolinium enhancement (LGE) transmural extent was categorized into 5 groups (G0-G4).
  • Left ventricular ejection fraction (LVEF) was evaluated and compared between ACAO, myocardial infarction (MI), and non-coronary artery occlusion (Non-CO) groups.

Main Results:

  • LVEF was significantly reduced in patients with LGE >50% (G3 and G4).
  • Patients with ACAO generally showed preserved LVEF (50.5±4.8%).
  • The MI group exhibited significantly lower LVEF (33.6±10.8%) compared to ACAO and Non-CO groups.

Conclusions:

  • Extensive LGE (>50%) is associated with left ventricular dysfunction.
  • Most ACAO patients post-KD have limited LGE (≤50%) and preserved LV function.
  • Subendocardial infarction with preserved LV function is common in ACAO patients.
Abstract

Keywords:
Asymptomatic coronary artery occlusionCardiac magnetic resonanceKawasaki diseaseLate gadolinium enhancementMyocardial infarction

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