title: Dobutamine stress radionuclide ventriculography reveals silent myocardial dysfunction in Kawasaki disease.
abstract: Dobutamine (DOB) stress radionuclide ventriculography (RVG) is proposed for evaluating left ventricular performance in patients with Kawasaki disease (KD). Dobutamine stress RVG, up to 15 microg x kg(-1) x min(-1), was performed in 40 patients with a history of KD, some of whom had a perfusion defect (PD group) on dipyridamole stress thallium-201 myocardial imaging, some of whom had no perfusion defects (NPD group), and some of whom had no coronary artery lesions (C group). No significant differences in either systolic or diastolic indices of the left ventricle at rest were observed between the 3 groups. Although hemodynamic responses were similar in all patients after DOB stress, early diastolic index of the first third filling fraction decreased only in the PD group and was significantly lower in this group compared with the C group (p<0.01). The asynchrony index increased significantly in those patients with coronary stenosis after DOB stress (p<0.05). No serious side-effects were observed during the study. Even late after onset, patients with myocardial ischemia as a result of KD still had impaired early diastolic filling and asynchronous relaxation of the left ventricle. As an alternative to exercise testing, DOB stress RVG is a safe and promising means for serially evaluating left ventricular performance in patients with KD.
authors: Department of Pediatrics, Toyama Medical & Pharmaceutical University, Japan.
authors: Yuji
authors: Y
authors: Hamamichi
authors: Fukiko
authors: F
authors: Ichida
authors: Shinichi
authors: S
authors: Tsubata
authors: Keiichi
authors: K
authors: Hirono
authors: Sayaka
authors: S
authors: Watanabe
authors: Chen
authors: C
authors: Rui
authors: Xianyi
authors: X
authors: Yu
authors: Kei-Ichiro
authors: K
authors: Uese
authors: Ikuo
authors: I
authors: Hashimoto
authors: Masashi
authors: M
authors: Simizu
authors: Hikaru
authors: H
authors: Seto
authors: Hideki
authors: H
authors: Origasa
authors: Toshio
authors: T
authors: Miyawaki
mesh_terms: D000293:Adolescent; D000318:Adrenergic beta-Agonists; D001794:Blood Pressure / Q000187:drug effects; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D004176:Dipyridamole; D004280:Dobutamine; D005080:Exercise Test / Q000379:methods; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015635:Radionuclide Ventriculography / Q000187:drug effects*; D013794:Thallium Radioisotopes; D016277:Ventricular Function, Left / Q000502:physiology / Q000528:radiation effects
chemical_list: D000318:Adrenergic beta-Agonists; D013794:Thallium Radioisotopes; D004280:Dobutamine; D004176:Dipyridamole