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Serial evaluation of myocardial function using the myocardial performance index in Kawasaki disease

World Journal of Pediatrics 2018年第3期14卷 259-268页

作者： Eun Song Song Somy Yoon Joo Hyun Cho Eun Mi Yang Hwa Jin Cho Young Youn Choi Jae Sook Ma gwang hyeon eom Young Kuk Cho Department of Pediatrics Chonnam National University HospitalChonnam National University Medical School42 Jebong-roDong-guGwangju 501-757South Korea Department of Pharmacology and Medical Research Center for Gene Regulation Chonnam National University Medical School160 Baekseo-roDong-guGwangju 61469South Korea Department of Pediatrics KS HospitalGwangjuSouth Korea

Background Kawasaki disease (KD) is known as systemic vasculitis, and more than half of the patients with KD have myo-carditis, which can induce ventricular dysfunction. In this study, we evaluate left ventricular (LV) dysfunction in patients with KD based on the myocardial performance index (MPI) using pulse Doppler (PD) and tissue Doppler imaging (TDI), from the acute to convalescent phases. Methods We retrospectively studied 89 children diagnosed with KD from January 2010 to August 2012. We assessed the presence of coronary artery lesions (CALs) and the LV ejection fraction, PD-MPI, and TDI-MPI at diagnosis, and 2, 14, and 56 days after intravenous immunoglobulin (IVIG) treatment. We enrolled 70 healthy children as a control group. Results The ejection fraction in patients with KD at diagnosis (67.3 ± 0.9%) was lower than that in the control group (69.8 ± 0.8%,P = 0.035), and the LV TDI-MPIs for patients with KD at diagnosis (0.49 ± 0.01) and 2 days after IVIG treatment (0.48 ± 0.01) were higher than those in the control group (0.45 ± 0.01,P = 0.002,P = 0.033, respectively). No signifi cant diff erences were found in the LV dysfunction between the patients with complete and incomplete KD. Septal TDI-MPIs in patients with KD with CAL at diagnosis (0.52 ± 0.02) were higher than those in patients with KD without CAL (0.47 ± 0.01,P = 0.019). Conclusions Transient LV dysfunction occurred in patients with complete and incomplete KD in the acute stage. In patients with KD with CAL at diagnosis, the LV dysfunction was more prominent. The PD-MPI and TDI-MPI are useful parameters for assessing LV function in patients with KD.

关键词： Kawasaki disease Myocardial function Myocardial performance index Tissue Doppler imaging

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