[Mitral regurgitation in the acute phase of Kawasaki disease: scrutiny using real-time two-dimensional Doppler flow imaging].
To study valvular lesions in the acute phase of Kawasaki disease, 17 patients who were admitted to our institution before the 12th day of their illness were examined using real-time two-dimensional Doppler flow imaging (2DD: Toshiba SSH 65A) from January to September 1986. Pulsed Doppler, continuous wave Doppler, and M-mode echocardiography were also performed. Patients were examined daily from their admission to 12th day of illness, and after that, more than twice a week until the 28th day of illness. Fourteen of the 17 patients underwent Ga-67 scintigraphy. Cardiac catheterization, including selective coronary arteriography, was performed in 15 patients in the convalescent phase. Mitral regurgitation (MR) was detected in eight of the 17 cases (47%). MR appeared on 2DD 7.5 +/- 1.6th day of illness (mean +/- SD), lasting until 11.9 +/- 5.7th day of illness. MR was transient and mild in degree in all cases, and the regurgitant jet was directed towards the left atrial posterior wall. Neither prolapse nor deformity of the mitral valve was detected. The left ventricular volume indices (determined by the Pombo method) measured by M-mode echocardiography in the acute and convalescent phases were compared. In the group with MR in the acute phase, the end-diastolic volume index was 66.9 +/- 19.9 ml/m2 and the end-systolic volume index was 21.0 +/- 11.7 ml/m2. These were significantly greater than those in the convalescent phase (51.3 +/- 13.1 ml/m2, 14.1 +/- 4.0 ml/m2, respectively). However, no significant differences were observed in the group without MR. Positive uptake of Ga-67 was observed in six patients with MR, but in none of the seven without MR. The incidence of positive uptake was significantly higher in the patients with MR. Cardiac catheterization performed in the convalescent phase revealed that no patient had the findings of MR, other valvular lesions, coronary arterial lesions, or abnormal ventricular performance.
Suzuki
A
A
Department of Pediatrics, National Cardiovascular Center, Suita.
Kamiya
T
T
Arakaki
Y
Y
Sato
I
I
Tsuchiya
K
K
Kohata
T
T
D000208:Acute Disease; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology*; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*