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Exercise echocardiography in children with Kawasaki disease: ventricular long axis is selectively abnormal
M Y Henein1, S Dinarevic, C A O'Sullivan
1Department of Pediatric Cardiology, Royal Brompton Hospital, London, England.
The American Journal of Cardiology
|June 19, 1998
Insights
Asymptomatic children with Kawasaki disease maintain normal heart function markers. However, stress reveals abnormal subendocardial function, especially in those with coronary aneurysms.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Physiology
- Kawasaki Disease Research
Background:
- Kawasaki disease (KD) is a leading cause of acquired pediatric heart disease.
- Subclinical cardiac dysfunction may persist in asymptomatic children post-KD.
- Coronary artery abnormalities are a known complication of KD.
Purpose of the Study:
- To assess left ventricular (LV) systolic and diastolic function in asymptomatic children with a history of Kawasaki disease.
- To evaluate the impact of stress on LV function, specifically long-axis mechanics.
- To compare cardiac function between KD patients with and without coronary aneurysms.
Main Methods:
- Echocardiography was used to evaluate LV systolic and diastolic function.
- Long-axis function was assessed, representing subendocardial function.
- Cardiac function was analyzed under resting and stress conditions.
Main Results:
- Asymptomatic children with KD maintained preserved traditional LV systolic and diastolic function markers.
- Long-axis function was found to be abnormal during stress.
- This abnormality in long-axis function was more pronounced in patients with coronary aneurysms compared to those without.
Conclusions:
- Traditional echocardiographic markers do not fully capture cardiac function in asymptomatic children with KD.
- Stress echocardiography reveals subtle myocardial dysfunction, particularly affecting the subendocardium.
- The presence of coronary aneurysms in KD patients is associated with more significant long-axis dysfunction under stress.
Abstract:
In asymptomatic children with Kawasaki disease, left ventricular traditional markers of systolic and diastolic function are maintained. However, long-axis function, which represents the subendocardium, is abnormal during stress, particularly in patients with versus without coronary aneurysm.