title: Evaluation of echogenicity of the heart in Kawasaki disease.
abstract: Pathologic studies of the heart in patients with Kawasaki disease (KD) revealed vasculitis, valvulitis, myocarditis, and pericarditis. However, there have been no studies on the quantitative determination of multi-site echogenicity of the heart in KD patients. It is also undetermined whether the degree of echogenicity of each site of the heart in patients with KD might be related to the response to intravenous immunoglobulin (IVIG) treatment. In 81 KD patients and 30 control subjects, we prospectively analyzed echogenicity of the heart. Echogenicity was measured in four sites: coronary artery wall (CAW), mitral valve (MV), papillary muscle (PM), and ascending aortic wall (AAo wall) by the calibrated integrated backscatters (cIBs). The cIB values of all measurement sites at acute phase in KD patients were significantly higher than those in control subjects (KD patients vs control subjects; CAW, 19.8 ± 6.2 dB vs 14.5 ± 2.0 dB, p < 0.05; MV, 23.3 ± 5.3 dB vs 16.0 ± 3.3 dB, p < 0.05; PM, 22.4 ± 5.1 dB vs 12.7 ± 1.9 dB, p < 0.05; AAo wall, 25.3 ± 5.6 dB vs 18.3 ± 3.4 dB, p < 0.05). The cIB values of CAW at the acute phase in IVIG nonresponders were significantly higher than those in responders. Conclusion: Echogenicity of the heart in KD patients at the acute phase increased not only in the coronary artery wall but also in other parts of the heart. Echogenicity of CAW might be helpful in determining the unresponsiveness of IVIG treatment.
authors.affiliation: Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City 812-8582, Japan. dadan@pediatr.med.kyushu-u.ac.jp
authors.forename: Hazumu
authors.initials: H
authors.lastname: Nagata
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Yamamura
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Uike
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Nakashima
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Hirata
authors.forename: Eiji
authors.initials: E
authors.lastname: Morihana
authors.forename: Yumi
authors.initials: Y
authors.lastname: Mizuno
authors.forename: Shiro
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Toshiro
authors.initials: T
authors.lastname: Hara
mesh_terms: D002648:Child; D002675:Child, Preschool; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006321:Heart; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D007564:Japan; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000000981:diagnostic imaging* / Q000628:therapy; D011446:Prospective Studies
chemical_list: D016756:Immunoglobulins, Intravenous