Ultrasound tissue characterization of the myocardium in patients after Kawasaki disease.
We sought to determine if changes in myocardial physical properties, detected by ultrasound tissue characterization (UTC), are present in asymptomatic children years after an acute episode of Kawasaki disease (KD) and if such changes are related to coronary artery aneurysms (CAs). Myocardial UTC analysis was performed 4.8 + or - 3.4 years after acute KD in 22 patients, mean age 6.6 + or - 3.4 years, with or without CA, who had a normal ECG and normal left ventricular (LV) systolic and diastolic function by echocardiography. Twenty-two age-matched subjects were studied as controls. Cyclic variation of integrated backscatter (cvIBS) and calibrated integrated backscatter (cIBS) were assessed in 16 LV myocardial segments in each patient and control. We found large differences in the UTC data between patients and controls: cvIBS, 7.8 + or - 0.8 vs 8.9 + or - 0.6 dB; cIBS, 28.6 + or - 3.2 vs 25.2 + or - 1.0 dB (P\10-3 for both). The average values of cIBS and cvIBS did not differ significantly between KD patients with and patients without CA or stenosis. In conclusion, UTC analysis demonstrated significant differences in myocardial tissue properties between KD patients and controls, despite similar measures of LV function, independent of coronary artery abnormalities. UTC analysis might improve risk stratification for KD patients.
Leonardi
Benedetta
B
Division of Pediatric Cardiology, Ospedale Bambino Gesu', Rome, Italy.
Giglio
Vincenzo
V
Sanders
Stephen P
SP
Pasceri
Vincenzo
V
De Zorzi
Andrea
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D009200:Myocardial Contraction / Q000502:physiology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D016277:Ventricular Function, Left / Q000502:physiology*
J Pediatr. 1992 Nov;121(5 Pt 1):684-8
1432414
J Am Coll Cardiol. 1995 May;25(6):1420-4
7722143
Am Heart J. 1996 Jan;131(1):115-21
8553997
Circulation. 2004 Oct 26;110(17):2747-71
15505111
Circulation. 1996 Nov 1;94(9):2103-6
8901658
Circulation. 1998 Feb 3;97(4):356-62
9468209
Pediatr Rev. 1996 May;17(5):153-62
8935914
Circulation. 2002 Jun 18;105(24):2878-84
12070117
J Am Soc Echocardiogr. 2000 Jan;13(1):9-17
10625826
Pediatrics. 1978 Jan;61(1):100-7
263836
Am J Cardiol. 2004 Jun 1;93(11):1357-61, A5
15165914
Circ Cardiovasc Imaging. 2010 Jan;3(1):86-93
19920028
Am J Cardiol. 1992 Feb 15;69(5):542-6
1736621
J Am Coll Cardiol. 1984 Jul;4(1):88-95
6736460
Pediatr Cardiol. 1993 Mar;14(2):67-74
8469634
Circulation. 1986 Aug;74(2):389-400
3524896
Circulation. 1994 Feb;89(2):916-22
8313588
Circulation. 1990 Jan;81(1):58-64
2404628
Lancet. 2004 Aug 7-13;364(9433):533-44
15302199
J Am Coll Cardiol. 1996 Sep;28(3):757-62
8772768
Clin Imaging. 2006 Nov-Dec;30(6):402-8
17101409
J Am Coll Cardiol. 1996 Jul;28(1):253-7
8752822
Ultrason Imaging. 1990 Jul;12(3):189-204
2368223
J Am Soc Echocardiogr. 1998 Oct;11(10):929-37
9804097
Arch Pathol Lab Med. 1986 Dec;110(12):1136-42
3778140
J Am Soc Echocardiogr. 2001 Jul;14(7):682-90
11447413
J Am Coll Cardiol. 2006 Feb 7;47(3):686-8
16458159
Circulation. 1989 Sep;80(3):491-503
2766504
Circulation. 2005 Apr 26;111(16):2119-25
15851619
Circulation. 1988 Feb;77(2):478-83
3338136
J Ultrasound Med. 2006 Aug;25(8):1009-19
16870894
Br Heart J. 1981 Mar;45(3):248-63
7008815