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Updated: Jul 31, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Left ventricular function assessment in Kawasaki disease by two-dimensional global longitudinal systolic strain with
Ehsan Aghaei Moghadam1, Maryam Taraz1, Aliakbar Zeinaloo1
1Cardiology Division, Pediatric Department, Children's Medical Center (Pediatric Center of Excellence), Tehran University of Medical Sciences, No. 346, Keshavarz Blvd, Tehran, 14188, Iran.
Insights
Strain echocardiography reveals persistent subendocardial involvement in children after Kawasaki disease. This advanced imaging technique helps detect subtle cardiac changes in asymptomatic patients, guiding effective management and follow-up care.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Imaging
- Rheumatology
Background:
- Kawasaki disease is an acute febrile vasculitis affecting young children, potentially causing decreased heart function.
- Subendocardial involvement may persist after acute Kawasaki disease, often undetected by standard M-mode echocardiography.
- Strain echocardiography offers a novel method to assess myocardial deformation and subendocardial changes.
Purpose of the Study:
- To evaluate stratified left ventricular function using strain echocardiography in children with a history of Kawasaki disease.
- To assess subendocardial involvement at least six months post-acute Kawasaki disease using two-dimensional speckle-tracking imaging.
- To compare global longitudinal peak systolic strain (GLPS) between children with and without a history of Kawasaki disease.
Main Methods:
- Two-dimensional speckle-tracking imaging was employed to assess GLPS.
- The study included 27 healthy children and 27 children with a history of Kawasaki disease (over 6 months prior).
- Automated function imaging technology was utilized for data acquisition.
Main Results:
- While M-mode echocardiography showed normal ejection fractions in both groups, strain echocardiography revealed significant differences.
- Global longitudinal peak strain (GLPS) was significantly lower in boys with a history of Kawasaki disease compared to controls (P=0.008).
- Specific cardiac segments, particularly those supplied by the Left Circumflex artery, showed significant differences in strain between the groups.
Conclusions:
- Strain echocardiography is effective in detecting persistent subendocardial involvement in asymptomatic children with a history of Kawasaki disease.
- This technique provides a better understanding of long-term cardiac condition in these patients.
- Early detection of subtle myocardial changes is crucial for effective management and follow-up of Kawasaki disease survivors.
Background:
Kawasaki disease is an acute febrile vasculitis of childhood mainly affecting children under 4 years of age. In the acute stage of the disease, heart function decreases and gradually returns to normal after treatment. However, subendocardial involvement may persist, which cannot be assessed by M-mode echocardiography. Strain echocardiography is a recently developed technique to assess subendocardial involvement of myocardial deformation. We aimed to study the stratified strain of left ventricular function in a Kawasaki patient at least 6 months after the acute stage of the disease with special conditions for entering the study using two-dimensional speckle-tracking imaging. Between September 2020 and October 2022, 27 healthy children and 27 children with a history of Kawasaki disease more than 6 months ago were evaluated using two-dimensional global longitudinal peak systolic strain with automated function imaging technology.
Results:
The mean age of patients was 5.6 years. With M-mode echocardiography, ejection fraction of each group was in the normal range. Mean (± standard deviation) global longitudinal peak strain in four-chamber view of girls with Kawasaki disease was - 23.74 ± 2.77, and that in boys with Kawasaki disease was - 20.93 ± 2.06 (P value = 0.008). GLPS (global longitudinal peak strain) was compared as an overall average and as in a separate segment, which showed significant difference in two comparisons. In our study, a decrease in the function of some cardiac segments is reported. Global longitudinal peak strain in four-chamber view was significantly lower in boys. Comparing different segments, a difference in global left ventricular long-axis strain was found between the two groups. On the other hand, there was a major difference between the two groups in the basal inferolateral, basal anterolateral, and mid-inferolateral, which receives blood from Left Circumflex artery.
Conclusion:
Using stain echocardiography to detect continued subendocardial involvement in asymptomatic children with a history of Kawasaki disease for a better understanding of the condition, effective management and follow-up is recommended.
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