Left ventricular function assessment in Kawasaki disease by two-dimensional global longitudinal systolic strain with...

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.