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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Is there myocardial involvement in children with long-term follow-up for Kawasaki disease? A study based on
Özlem Kayabey1, Tunç Tuncer2, Murat Deveci3
1Department of Pediatric Cardiology, Kocaeli University Faculty of Medicine Kocaeli, Turkey.
Insights
Strain echocardiography did not reveal subclinical myocardial dysfunction in children with Kawasaki disease long-term. However, strain values varied with follow-up, suggesting potential late left ventricular dysfunction requiring monitoring.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Imaging
- Rheumatic Diseases
Background:
- Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
- Myocardial involvement is a concern in the late phase of KD.
- Strain echocardiography offers sensitive assessment of myocardial function.
Purpose of the Study:
- To investigate subclinical myocardial dysfunction in children with KD using strain echocardiography during long-term follow-up.
- To assess the correlation between cardiac function parameters and follow-up duration in KD patients.
Main Methods:
- A cohort of 30 children with KD (follow-up ≥12 months) and 30 healthy controls underwent standard echocardiography, Doppler, and strain echocardiography.
- Left ventricular strain and strain rate parameters were analyzed from apical views.
- Statistical analysis correlated strain parameters with follow-up duration.
Main Results:
- Conventional echocardiography and Doppler indices showed no significant differences between KD patients and controls.
- Left ventricular strain and strain rate parameters did not differ statistically between groups.
- Positive correlations were observed between follow-up duration and longitudinal strain values; a negative correlation was found for radial strain.
Conclusions:
- Strain echocardiography did not detect subclinical myocardial dysfunction in the long-term follow-up of KD.
- Variability in strain values with follow-up duration suggests potential for late left ventricular dysfunction.
- Long-term monitoring of children diagnosed with KD is crucial for detecting potential cardiac sequelae.
Objective:
This study aimed to determine the possibility of subclinical myocardial dysfunction detected by strain echocardiography in the late period of children with Kawasaki disease.
Material And Methods:
The study enrolled 30 patients with Kawasaki disease with a follow-up period of at least 12 months and 30 healthy age- and gender-matched children. During the follow-up period, standard echocardiography, pulsed and tissue Doppler, and strain echocardiography were recorded for both groups.
Results:
The mean age at the time of the diagnosis was 2.6±2.3 years (2 months-11 years). The mean follow-up period after the diagnosis was 3.55±2.20 years. Conventional echocardiography, M mode, pulsed and tissue Doppler values, and myocard performance index did not reveal significant differences. Left ventricle strain and strain rate parameters obtained by apical four-, three-, and two-chamber views did not show statistical differences between patients and controls. There was a positive correlation between the duration of follow-up and global four- and three-chamber longitudinal strain and global longitudinal strain values (r=0.465, p=0.010; r=0.414, p=0.023; r=0.492, p=0.006, respectively), whereas global radial strain showed negative correlation (r=-0.517, p=0.003).
Conclusion:
The analysis of systolic strain and strain rate did not detect a subclinical myocardial dysfunction in the long-term follow-up of Kawasaki disease. However, strain values showed variability with the follow-up periods, which indicates that Kawasaki disease might cause left ventricular dysfunction in the later phases. Therefore, a follow-up of children with a diagnosis of Kawasaki disease is of capital importance.
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