Left Atrial Strain in Multisystem Inflammatory Syndrome in Children and Associations with Systemic Inflammation and
Bryan M Jepson1,2, Matthew Beaver3, John L Colquitt3
1Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA. bjepson@chc-pa.org.
Pediatric Cardiology
|February 15, 2024
Summary
Left atrial strain (LAS) parameters were reduced in children with multisystem inflammatory syndrome (MIS-C), indicating diastolic dysfunction. LAS analysis, especially the absence of a LAS-ct peak, shows promise for detecting subclinical cardiac issues in MIS-C patients.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Imaging
- Inflammatory Diseases
Background:
- Multisystem inflammatory syndrome in children (MIS-C) frequently causes cardiac injury, affecting both systolic and diastolic functions.
- Left atrial strain (LAS) is a sensitive measure of subclinical diastolic dysfunction in adults, but its utility in children with MIS-C is understudied.
- Early detection of cardiac dysfunction in MIS-C is crucial for timely intervention and improved patient outcomes.
Purpose of the Study:
- To evaluate left atrial strain (LAS) parameters in children diagnosed with MIS-C.
- To assess the association between LAS parameters and systemic inflammation markers.
- To determine the relationship between LAS and cardiac injury markers in MIS-C patients.
Main Methods:
- A retrospective cohort study comparing 118 MIS-C patients with 20 healthy controls.
- Echocardiographic assessment of LAS parameters (LAS-r, LAS-cd, LAS-ct) at admission.
- Comparison of LAS between MIS-C patients with and without cardiac injury (defined by elevated BNP or troponin-I).
- Correlation and logistic regression analyses with inflammatory and cardiac biomarkers; reliability testing performed.
Main Results:
- MIS-C patients exhibited significantly reduced LAS parameters (LAS-r, LAS-cd, LAS-ct) compared to healthy controls.
- Reduced LAS parameters were also observed in MIS-C patients with cardiac injury compared to those without.
- A discrete LAS-ct peak was absent in 55% of MIS-C patients versus 0% of controls; LAS parameters showed moderate correlations with inflammatory markers (ESR, procalcitonin) and cardiac biomarkers (BNP).
- No strain parameters on admission were independently associated with cardiac injury.
Conclusions:
- Left atrial strain analysis, particularly the absence of a LAS-ct peak, is a reproducible method that may be superior to conventional echocardiography for detecting diastolic dysfunction in pediatric MIS-C.
- While LAS parameters are reduced in MIS-C and correlate with inflammation and cardiac injury markers, they were not independently associated with the presence of cardiac injury on admission.
- Further research is warranted to explore the prognostic value of LAS in MIS-C.
Keywords:
Diastolic functionEchocardiographyLeft atrial strainMultisystem inflammatory syndrome in childrenSpeckle trackingMore Related Videos
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