Longitudinal Assessment of Cardiac Function Following Multisystem Inflammatory Syndrome in Children Associated with...

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Critical Care Medicine

Background:

• Multisystem inflammatory syndrome in children (MIS-C) following COVID-19 frequently presents with cardiac complications.
• Myocardial dysfunction, evidenced by reduced ejection fraction and abnormal strain, is common during acute MIS-C.
• Longitudinal data on cardiac outcomes in pediatric MIS-C patients remain limited.

Purpose of the Study:

• To characterize the temporal evolution of cardiac findings in children diagnosed with MIS-C.
• To assess cardiac function and deformation from acute illness through a minimum of 2-month follow-up.
• To identify predictors of cardiac dysfunction and recovery patterns in pediatric MIS-C.

Main Methods:

• Retrospective review of 36 pediatric patients with MIS-C admitted between April 2020 and September 2021.
• Analysis of echocardiographic data, including left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS).
• Cardiac assessments were performed at initial presentation, discharge, 2-4 week, and ≥2-month follow-up visits.

Main Results:

• At presentation, 42% of MIS-C patients had reduced LVEF (<55%), and 44% of those with GLS measured had abnormal strain (< -18%).
• Among patients with normal LVEF at presentation, 22% exhibited abnormal GLS, suggesting subclinical myocardial impairment.
• While 90% of patients with initially reduced LVEF showed normalization by discharge, 21% had persistently abnormal GLS at 2-month follow-up.

Conclusions:

• Myocardial systolic dysfunction and impaired deformation are prevalent in pediatric MIS-C at initial presentation.
• Although LVEF generally recovers by 2 months, persistent abnormalities in GLS suggest ongoing subclinical cardiac dysfunction.
• The study indicates a generally optimistic prognosis for cardiac recovery in MIS-C, but longitudinal monitoring is essential.