title: Impact of intravenous immunoglobulin infusion on longitudinal left ventricular performance in patients with acute Kawasaki disease of usual course.
abstract: OBJECTIVE
  To determine the acute change in cardiac performance after intravenous immunoglobulin infusion (IVIG) in patients with acute Kawasaki disease (KD).
  
  
  METHODS
  Subjects were 33 patients with KD who were treated with IVIG 2 g/kg and recovered without coronary artery lesion and 27 controls. Subjects underwent combined two-dimensional, Doppler, and tissue Doppler echocardiographic (TDI) studies. In KD, these echocardiographic studies were performed before IVIG, 48 h after IVIG, and in convalescence. Echocardiographic variables were compared between KD and controls as well as among 3 time points in KD.
  
  
  RESULTS
  Before IVIG, KD showed significantly higher peak aortic velocity and shorter aortic ejection time as results of tachycardia and significantly lower E' (p<0.04) but significantly higher E/E' (p<0.02). After IVIG, patients with KD became afebrile and showed significantly lower TDI indices such as S', E', and, A' and isovolumic acceleration (IVA) (163+/-56 vs. 208+/-70 cm/s(2), p<0.01) with higher TDI-derived Tei index (0.50+/-0.10 vs. 0.44+/-0.06, p<0.02) than controls. These differences tended to disappear in convalescence. In analysis of repeated measurements, except for hemodynamic changes associated with tachycardia, S' (7.9+/-1.3 vs. 7.0+/-1.1 vs. 7.4+/-0.9 cm/s, p<0.001), IVA (227+/-72 vs. 163+/-56 vs. 180+/-63, p<0.05), and A' (7.7+/-3.0 vs. 5.6+/-1.3 vs. 6.7+/-2.3 cm/s, p<0.001) were significantly different among these time points.
  
  
  CONCLUSIONS
  In patients with acute KD with usual course, IVIG induced transient sub-clinical longitudinal left ventricular dysfunction.
authors.affiliation: Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Koteda
authors.forename: Kenji
authors.initials: K
authors.lastname: Suda
authors.forename: Shintaro
authors.initials: S
authors.lastname: Kishimoto
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ito
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kudo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishino
authors.forename: Haruka
authors.initials: H
authors.lastname: Ishii
authors.forename: Motofumi
authors.initials: M
authors.lastname: Iemura
authors.forename: Toyojiro
authors.initials: T
authors.lastname: Matuishi
mesh_terms: D002675:Child, Preschool; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000494:pharmacology*; D007262:Infusions, Intravenous; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D016756:Immunoglobulins, Intravenous