Four-year cardiac geometry, blood pressure, and immune profiles after multisystem inflammatory syndrome in children

To evaluate left ventricular geometry, haemodynamic load, and inflammatory markers with multisystem inflammatory syndrome in children.

This retrospective study included paediatric patients with a prior diagnosis of multisystem inflammatory syndrome in children who underwent follow-up echocardiography, ambulatory blood pressure monitoring, and laboratory assessments.

Thirty patients (mean age 12.9 ± 5.0 years; 18 boys) were evaluated, including eight (26.7%) who had required an ICU stay during the acute phase. The median interval since the diagnosis of multisystem inflammatory syndrome in children was 48 months (interquartile range 47-50). Body mass index was positively correlated with left ventricular end-diastolic diameter (r = 0.577, p = 0.001), left ventricular end-systolic diameter (r = 0.522, p = 0.002), interventricular septal thickness (r = 0.565, p = 0.001), posterior wall thickness (r = 0.610, p < 0.001), and left ventricular mass (r = 0.594, p = 0.001). Body mass index z-score correlated with interleukin-6 (r = 0.415, p = 0.023), while lymphocyte count correlated inversely with left ventricular end-diastolic diameter (r = -0.559, p = 0.001) and left ventricular mass (r = -0.631, p < 0.001). Multivariate analysis identified lymphocyte count as the only independent predictor of left ventricular end-diastolic diameter [β = -0.492, 95% confidence interval = -0.589 to -0.078, p = 0.013].

Four years after multisystem inflammatory syndrome in children, ventricular enlargement appears to reflect physiological scaling rather than persistent hypertrophy, supporting the need for continued long-term surveillance in this population.