title: Extracoronary echocardiographic findings as predictors of coronary artery lesions in the initial phase of Kawasaki disease.
abstract: OBJECTIVE
  To describe the significance of pericardial effusion (PE), mitral regurgitation (MR) and impaired systolic function in predicting coronary artery lesions (CAL) at diagnosis and follow-up in Kawasaki disease (KD).
  
  
  METHODS
  Echocardiographic records on admission, at 1-3 weeks of illness, and at 6-8 weeks of illness were retrospectively retrieved in children with acute KD treated by intravenous immunoglobulins.
  
  
  METHODS
  The study included 194 consecutive children (113 male; median age 2.1 years) in a paediatric cardiology tertiary care centre, from 1988 to 2007.
  
  
  RESULTS
  Overall, children with CAL (64/194) were more likely to have PE (OR=3.00, CI 1.34 to 6.72) and MR (OR=2.51, CI 1.22 to 5.16) at diagnosis; PE was the sole echocardiographic abnormality associated with CAL in multivariable analysis. These abnormalities were predictive of the presence of CAL at the first echocardiography in the acute phase of the disease only. MR, systolic dysfunction and PE were not associated with persistence of CAL in the convalescent phase. Male gender, CAL size and resistance to immunoglobulin treatment were independent factors predictive of the persistence of CAL.
  
  
  CONCLUSIONS
  Children with MR or PE should undergo careful assessment of coronary status at diagnosis. However, PE or MR at diagnosis is not predictive of persistent CAL at follow-up.
authors.affiliation: Department of Pediatric Cardiology, Louis Pradel Hospital, Claude Bernard University Lyon I, University of Lyon, Lyon 69677, France.
authors.forename: Jean Christophe
authors.initials: JC
authors.lastname: Lega
authors.forename: André
authors.initials: A
authors.lastname: Bozio
authors.forename: Rolando
authors.initials: R
authors.lastname: Cimaz
authors.forename: Magali
authors.initials: M
authors.lastname: Veyrier
authors.forename: Daniel
authors.initials: D
authors.lastname: Floret
authors.forename: Corinne
authors.initials: C
authors.lastname: Ducreux
authors.forename: Philippe
authors.initials: P
authors.lastname: Reix
authors.forename: Sylvie
authors.initials: S
authors.lastname: Di Filippo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000628:therapy; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012189:Retrospective Studies
chemical_list: D016756:Immunoglobulins, Intravenous