Cardiac involvement in multisystem inflammatory syndrome in children: single-centre experience

Area of Science:

• Pediatric Cardiology
• Pediatric Infectious Diseases
• Pediatric Critical Care

Background:

• Multisystem inflammatory syndrome in children (MIS-C) is a serious condition with potential cardiac complications.
• Evaluating cardiac involvement and identifying prognostic factors in MIS-C is crucial for patient management.

Purpose of the Study:

• To assess electrocardiographic and echocardiographic findings in children with MIS-C.
• To analyze 24-hour Holter recordings for arrhythmias.
• To identify predictors of cardiac dysfunction in MIS-C.

Main Methods:

• Retrospective review of demographic, clinical, and laboratory data from 67 children with MIS-C.
• Analysis of electrocardiograms, echocardiograms (including ejection fraction), and 24-hour Holter monitoring.
• Correlation of laboratory markers with cardiac function and outcomes.

Main Results:

• 14.9% of patients exhibited systolic dysfunction (ejection fraction ≤ 55%).
• Elevated B-type natriuretic peptide levels correlated with C-reactive protein, ferritin, and fibrinogen.
• B-type natriuretic peptide effectively differentiated between patients with and without reduced ejection fraction.

Conclusions:

• Higher levels of neutrophil/lymphocyte ratio, C-reactive protein, D-dimer, ferritin, troponin, and B-type natriuretic peptide indicate systolic dysfunction in MIS-C.
• A B-type natriuretic peptide cut-off of 1700 pg/ml was significantly effective in predicting systolic dysfunction.
• These biomarkers may help assess MIS-C severity, warranting further prospective research.