Echocardiographic Strain Evaluation Shows Persistent Echocardiographic Changes at 1 Year after Diagnosis of
Jihye You1,2
1Department of Pediatrics, Children's Hospital, Jeonbuk National University, Jeonju 54896, Republic of Korea.
Insights
Children with multisystem inflammatory syndrome (MIS-C) show persistent cardiac dysfunction a year after diagnosis. Echocardiographic follow-up is crucial for managing these long-term effects of COVID-19.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Cardiovascular Imaging
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a serious complication of COVID-19.
- Cardiac involvement is common in MIS-C, but long-term echocardiographic outcomes require further investigation.
Purpose of the Study:
- To evaluate the long-term echocardiographic impact of MIS-C on pediatric patients.
- To compare cardiac function in MIS-C patients with a healthy control group over time.
Main Methods:
- Retrospective analysis of echocardiographic data from 22 MIS-C patients and 22 healthy controls.
- Comparison of cardiac parameters at diagnosis and 1-year follow-up.
Main Results:
- MIS-C patients exhibited reduced left ventricular ejection fraction (LVEF), longitudinal strain, and global longitudinal strain (GLS) at diagnosis and 1-year follow-up.
- Persistent diminished right ventricular function was noted in MIS-C patients.
- Despite changes, LVEF and coronary artery z-scores normalized over time.
Conclusions:
- MIS-C leads to persistent cardiac alterations, particularly affecting ventricular function.
- Long-term echocardiographic monitoring is recommended for children with MIS-C to understand and manage post-COVID-19 cardiac sequelae.
Abstract:
Coronavirus disease (COVID-19) is a global pandemic causing multisystem inflammatory syndrome in children (MIS-C). This study evaluated the long-term echocardiographic impact of MIS-C on patients and compared it with that in a healthy control group. Data from 22 children with MIS-C admitted to Jeonbuk National University Hospital and 22 healthy children (control group) were retrospectively analyzed. Echocardiographic data were compared at two distinct time points: diagnosis and 1-year follow-up. At diagnosis, the MIS-C cohort exhibited significantly reduced left ventricular ejection fraction (LVEF), longitudinal strain across the apical 4- and 2-chamber views, and global longitudinal strain (GLS). At 1-year follow-up, the reduced LVEF in the apical 4-chamber, overall longitudinal strain in the apical 4-chamber, and GLS persisted. However, the right ventricular free wall and global strain remained diminished compared with those in the control group. Despite significant changes over time, the LVEF and longitudinal strain in the apical 4-chamber and z-scores of all coronary arteries were normal at baseline and 1-year follow-up. Persistent cardiac alterations were observed in patients with MIS-C, particularly in both ventricular functions. Therefore, middle- to long-term echocardiographic follow-up may help improve understanding and management of long-term echocardiographic implications in patients with post-COVID-19 syndrome.
