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Updated: Dec 18, 2025
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Left ventricular systolic dyssynchrony in patients with Kawasaki disease: a real-time three-dimensional
Haiyong Wang1, Yan Song1, Jingjing Mu1
1The Department of Ultrasound Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, No 277, Yanta West Road, Xi'an, 710061, Shaanxi Province, China.
Insights
Systolic dyssynchrony is common in children with Kawasaki disease (KD), particularly those with coronary artery aneurysms (CAA). Real-time 3D echocardiography (RT3DE) effectively quantifies this dyssynchrony, which correlates with reduced heart function.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Echocardiography
Background:
- Left ventricular (LV) systolic dyssynchrony index (SDI) is a key prognostic indicator in cardiovascular diseases.
- The characteristics and implications of SDI in Kawasaki disease (KD) patients remain largely unexplored.
- Understanding SDI in KD is crucial for assessing cardiac function and prognosis.
Purpose of the Study:
- To identify and quantify SDI in KD patients across different disease phases using RT3DE.
- To investigate the association between SDI and LV systolic dysfunction in KD.
- To determine if SDI differs between KD patients with and without coronary artery aneurysms (CAA).
Main Methods:
- Seventy KD patients and 70 age/sex-matched controls were enrolled.
- SDI was calculated using real-time 3D echocardiography (RT3DE) based on a 17-segment LV model.
- 16-segment SDI (16-SDI%) and 12-segment SDI (12-SDI%) were measured as the standard deviation of segmental time-to-minimum-systolic-volume.
Main Results:
- Acute phase KD patients showed significantly higher 16-SDI% and 12-SDI% compared to controls.
- KD patients with CAA exhibited higher SDI values than those without CAA, both in acute and convalescent phases.
- A significant negative correlation was found between 16-SDI% and LV ejection fraction (r = -0.845, P < 0.001).
Conclusions:
- Mechanical dyssynchrony is prevalent in acute KD and persists in patients with CAA even in the convalescent phase.
- Increased LV systolic dyssynchrony is associated with impaired LV systolic function in KD patients.
- RT3DE is a valuable tool for quantifying dyssynchrony and assessing cardiac function in KD.
Abstract:
The left ventricular (LV) systolic dyssynchrony index (SDI) is an important prognostic indicator for many cardiovascular diseases; however, the characteristics of the SDI in patients with Kawasaki disease (KD) are unknown. In this study, we aimed to identify and quantify the SDI using real-time three-dimensional echocardiography (RT3DE) in KD patients during different phases. In addition, we intended to explore whether the SDI is associated with systolic dysfunction. Seventy consecutive KD patients and seventy age- and sex-matched controls were enrolled. The SDIs (percent of cardiac cycle) of 16 segments (16-SDI%) and 12 segments (12-SDI%) were calculated based on the defined standard deviation of each segment time from end diastole to the minimal systolic volume according to the 17-segment model (apex excluded). In the acute phase, the 16-SDI% and 12-SDI% were significantly higher in KD patients than in controls (4.40 ± 0.14 vs. 1.98 ± 0.12, P = 0.000; 3.55 ± 1.21 vs. 1.67 ± 0.93, P = 0.009, respectively), and patients with coronary artery aneurysm (CAA) exhibited higher 16-SDI% (P = 0.021) and 12-SDI% (P = 0.034) than patients without CAA. In the convalescent phase, patients with CAA still had higher 16-SDI% (P = 0.002) and 12-SDI% (P = 0.031) than controls, while the SDI in patients without CAA recovered to normal. The 16-SDI% was negatively correlated with the LV ejection fraction obtained from RT3DE (r = - 0.845, P = 0.000). Mechanical dyssynchrony is prevalent in KD patients during the acute phase and transient in patients without CAA, while patients with CAA still have impaired synchrony even in the convalescent phase. LV systolic dysfunction is associated with increased dyssynchrony. RT3DE is a valuable modality for identifying and quantifying dyssynchrony in KD patients.
