Evaluation of Long-Term Cardiac Function in MIS-C Patients Using Speckle Tracking Echocardiography.

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Cardiovascular Imaging

Background:

• Multisystem inflammatory syndrome in children (MIS-C) frequently involves cardiac complications, affecting 67%-80% of cases.
• While acute cardiac symptoms often resolve quickly post-treatment, long-term cardiac sequelae of MIS-C remain understudied.

Purpose of the Study:

• To evaluate the long-term cardiac functional changes in children diagnosed with MIS-C.
• To assess the utility of advanced echocardiographic techniques, specifically speckle tracking echocardiography (STE), in detecting subtle cardiac abnormalities post-MIS-C.

Main Methods:

• Cardiac function was assessed in 40 MIS-C patients using conventional echocardiography (ECHO), electrocardiography (ECG), STE, and cardiac MRI at diagnosis and 3- and 6-month follow-ups.
• STE was employed to detect regional myocardial contraction abnormalities, complementing conventional ECHO and cardiac MRI assessments.

Main Results:

• Conventional ECHO showed rapid normalization of cardiac function, with no abnormalities in left ventricle ejection fraction (LVEF) or fractional shortening (LVFS) at 3 months.
• STE identified persistent, though improving, regional contraction abnormalities in specific left ventricular segments at 3 and 6 months.
• Cardiac MRI in a subset of patients at 1 year showed normal results, suggesting resolution of underlying pathology.

Conclusions:

• Cardiac manifestations of MIS-C demonstrate rapid improvement with treatment.
• Speckle tracking echocardiography (STE) is crucial for identifying and monitoring subclinical regional cardiac dysfunction in MIS-C patients, offering insights beyond conventional methods.