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Evaluation of myocardial deformation in patients with Kawasaki disease using speckle-tracking echocardiography during mid-term follow-up

Published online by Cambridge University Press:  05 April 2017

Reyhan Dedeoglu ,
Kenan Barut ,
Funda Oztunc ,
Sezen Atik ,
Amra Adrovic ,
Sezgin Sahin ,
Dicle Cengiz  and
Ozgur Kasapcopur
Reyhan Dedeoglu*
Affiliation:
Pediatric Cardiology, Dr. Siyami Ersek Chest, Heart and Vessel Surgery Teaching and Research Hospital, Siyami Ersek Hospital, Istanbul, Turkey
Kenan Barut
Affiliation:
Pediatric Cardiology, Dr. Siyami Ersek Chest, Heart and Vessel Surgery Teaching and Research Hospital, Siyami Ersek Hospital, Istanbul, Turkey
Funda Oztunc
Affiliation:
Pediatric Cardiology, Dr. Siyami Ersek Chest, Heart and Vessel Surgery Teaching and Research Hospital, Siyami Ersek Hospital, Istanbul, Turkey
Sezen Atik
Affiliation:
Pediatric Cardiology, Dr. Siyami Ersek Chest, Heart and Vessel Surgery Teaching and Research Hospital, Siyami Ersek Hospital, Istanbul, Turkey
Amra Adrovic
Affiliation:
Pediatric Cardiology, Dr. Siyami Ersek Chest, Heart and Vessel Surgery Teaching and Research Hospital, Siyami Ersek Hospital, Istanbul, Turkey
Sezgin Sahin
Affiliation:
Pediatric Cardiology, Dr. Siyami Ersek Chest, Heart and Vessel Surgery Teaching and Research Hospital, Siyami Ersek Hospital, Istanbul, Turkey
Dicle Cengiz
Affiliation:
Pediatric Cardiology, Dr. Siyami Ersek Chest, Heart and Vessel Surgery Teaching and Research Hospital, Siyami Ersek Hospital, Istanbul, Turkey
Ozgur Kasapcopur
Affiliation:
Pediatric Cardiology, Dr. Siyami Ersek Chest, Heart and Vessel Surgery Teaching and Research Hospital, Siyami Ersek Hospital, Istanbul, Turkey
*
Correspondence to: R. Dedeoglu, MD, Department of Pediatric Cardiology, Cerrahpaşa Medical Faculty, Istanbul, Turkey. Tel: +90 506 474 38 58; Fax: +90 (212) 632 00 50; E-mail: reyhandedeoglu@gmail.com
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Abstract

Speckle-tracking echocardiography is a recently developed technique for the evaluation of myocardial deformation or strain. Our objective was to examine strain through a mid-term follow-up of patients with Kawasaki disease.

Methods

We explored left ventricular mechanics using speckle-tracking echocardiography in 35 patients with a history of Kawasaki disease at least 6 months after the acute phase. We also included 30 healthy children as controls. Strain data sets were acquired for the quantification of left ventricular global strain, segmental strain, and left ventricular ejection fraction.

Results

The mean age of our patients was 25.6±15.4 months. At a median follow-up of 57.5 months (16.5–98.2), although both values were in the normal range, the mean left ventricular ejection proportion of patients (57.3%) was a little lower than that of controls (p⩽0.05). Patient strain values at the basal inferoseptal (20.0), basal anterolateral (19.5), apical septal (23.3), and apical inferior (24.0) segments were lower compared with controls. In all, seven patients had coronary aneurysms during follow-up. Kawasaki disease patients with pyuria had lower left ventricular strain at the mid anterior, mid anteroseptal, apical anterior, and apical inferior segments and global longitudinal strain compared with patients with no pyuria (p⩽0.05).

Conclusion

In children with a history of Kawasaki disease, impairment of left ventricular mechanics occurs especially within the left anterior descending artery territories.

Keywords

Myocardial deformationspeckle-tracking echocardiographyKawasaki diseasestrainmyocarditis

Information

Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 7 , September 2017 , pp. 1377 - 1385
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Copyright
© Cambridge University Press 2017 

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References

1. Barut, K, Sahin, S, Kasapcopur, O. Pediatric vasculitis. Curr Opin Rheumatol 2016; 28: 29–38.Google Scholar
2. Kawasaki, T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children (in Japanese). Arerugi 1967; 16: 178–222.Google Scholar
3. Gordon, JB, Kahn, AM, Burns, JC. When children with Kawasaki disease grow up: myocardial and vascular complications in adulthood. J Am Coll Cardiol 2009; 54: 1911–1920.Google Scholar
4. Nakamura, Y, Yashiro, M, Uehara, R, et al. Epidemiologic features of Kawasaki disease in Japan: results from the nationwide survey in 2005–2006. J Epidemiol 2008; 18: 167–172.CrossRefGoogle ScholarPubMed
5. Ravekes, WJ, Colan, SD, Gauvreau, K, et al. Aortic root dilation in Kawasaki disease. Am J Cardiol 2001; 87: 919–922.Google Scholar
6 Gorcsan, J 3rd, Tanaka, H. Echocardiographic assessment of myocardial strain. J Am Coll Cardiol 2011; 58: 1401–1403.Google Scholar
7. Mor-Avi, V, Lang, RM, Badano, LP, et al. Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography. Eur J Echocardiogr 2011; 12: 167.Google Scholar
8. Yu, JJ, Choi, HS, Kim, YB, et al. Analyses of left ventricular myocardial deformation by speckle-tracking imag¬ing during the acute phase of Kawasaki disease. Pediatr Cardiol 2010; 31: 807–812.CrossRefGoogle ScholarPubMed
9. Xu, QQ, Ding, YY, Lv, HT, et al. Evaluation of left ventricular systolic strain in children with Kawasaki disease. Pediatr Cardiol 2014; 35: 1191–1197.Google Scholar
10. Newburger, JW, Takahashi, M, Gerber, MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2004; 110: 2747–2771.Google Scholar
11. Kaluzynski, K, Chen, X, Emelianov, SY, et al. Strain rate imaging using two-dimensional speckle tracking. IEEE Trans Ultrason Ferroelectr Freq Control 2001; 48: 1111–1112.CrossRefGoogle ScholarPubMed
12. Reisner, SA, Lysyansky, P, Agmon, Y, et al. Global longitudinal strain: a novel index of left ventricular systolic function. J Am Soc Echocardiogr 2004; 17: 630–633.CrossRefGoogle ScholarPubMed
13. Levy, P, Machefsky, A, Sanchez, AA, et al. Reference ranges of left ventricular strain measures by two-dimensional speckle-tracking echocardiography in children: a systematic review and meta-analysis. J Am Soc Echocardiogr 2016; 29: 209–225.Google Scholar
14. Mertens, L, Ganame, J, Claus, P, et al. Early regional myocardial dysfunction in young patients with Duchenne muscular dystrophy. J Am Soc Echocardiogr 2008; 21: 1049–1054.Google Scholar
15. Marcus, KA, Barends, M, Morava-Kozicz, E, et al. Early detection of myocardial dysfunction in children with mitochondrial disease: an ultrasound and two-dimensional strain echocardiography study. Mitochondrion 2011; 11: 405–412.Google Scholar
16. Dedobbeleer, C, Rai, M, Donal, E, et al. Normal left ventricular ejection fraction and mass but subclinical myocardial dysfunction in patients with Friedreich’s ataxia. Eur Heart J Cardiovasc Imaging 2012; 13: 346–352.Google Scholar
17. Nakai, H, Takeuchi, M, Nishikage, T, et al. Subclinical leftventricular dysfunction in asymptomatic diabetic patients assessed by two-dimensional speckle tracking echocardiography: correlation with diabetic duration. Eur J Echocardiogr 2009; 10: 926–932.Google Scholar
18. Poterucha, JT, Kutty, S, Lindquist, RK, et al. Changes in left ventricular longitudinal strain with anthracycline chemotherapy in adolescents precede subsequent decreased left ventricular ejection fraction. J Am Soc Echocardiogr 2012; 25: 733–740.Google Scholar
19. Sawaya, H, Sebag, IA, Plana, JC, et al. Assessment of echocardiography and biomarkers for the extended prediction of cardiotoxicity in patients treated with anthracyclines, taxanes and trastuzumab. Circ Cardiovasc Imaging 2012; 5: 596–603.CrossRefGoogle ScholarPubMed
20. Fallah-Rad, N, Walker, JR, Wassef, A, et al. The utility of cardiac biomarkers, tissue velocity and strain imaging, and cardiac magnetic resonance imaging in predicting early left ventricular dysfunction in patients with human epidermal growth factor receptor II-positive breast cancer treated with adjuvant trastuzumab therapy. J Am Coll Cardiol 2011; 57: 2263–2270.Google Scholar
21. Yu, W, Wong, SJ, Cheung, YF. Left ventricular mechanics in adolescents and young adults with a history of Kawasaki disease: analysis by three-dimensional speckle tracking echocardiography. Echocardiography 2014; 31: 483–491.CrossRefGoogle Scholar
22. Yutani, C, Go, S, Kamiya, T, et al. Cardiac biopsy of Kawasaki disease. Arch Pathol Lab Med 1981; 105: 470–473.Google Scholar
23. Fujiwara, H, Hamashima, Y. Pathology of the heart in Kawasaki disease. Pediatrics 1978; 61: 100–107.CrossRefGoogle ScholarPubMed
24. Dahdah, N, Siles, A, Fournier, A, et al. Natriuretic peptide as an adjunctive diagnostic test in the acute phase of Kawasaki disease. Pediatr Cardiol 2009; 30: 810–817.Google Scholar
25. Newburger, JW, Sanders, SP, Burns, JC, et al. Left ventricular contractility and function in Kawasaki syndrome. Circulation 1989; 79: 1237–1246.Google Scholar
26. Dahdah, N. Not just coronary arteritis, Kawasaki disease is a myocarditis, too. J Am Coll Cardiol 2010; 55: 1507–1507.CrossRefGoogle ScholarPubMed
27. Watanabe, T, Abe, Y, Sato, S, et al. Hyponatremia in Kawasaki disease. Pediatr Nephrol 2006; 21: 778–781.Google Scholar
28. Toru, W. Pyuria in patients with Kawasaki disease. World J Clin Pediatr 2015; 4: 25–29.Google Scholar
29. Mason, WH, Schneider, T, Takahashi, M. The epidemiology and etiology of Kawasaki disease. Cardiol Young 1991; 1: 196–205.Google Scholar
30. Sepahi, MA, Miri, R, Ahmadi, HT. Association of speckle-tracking echocardiography rile pyuria and coronary artery aneurysm in Kawasaki syndrome. Acta Med Iran 2011; 49: 606–611.Google Scholar
31. Senzaki, H. Long-term outcome of Kawasaki disease. Circulation 2008; 118: 2763–2772.CrossRefGoogle ScholarPubMed
32. Guidelines for treatment and management of cardiovascular sequelae in Kawasaki disease. Subcommittee of Cardiovascular Sequelae, Subcommittee of Surgical Treatment, Kawasaki Disease Research Committee. Heart Vessels 1987; 3: 50.Google Scholar
33. Colquitt, JL, Pignatelli, RH. Strain imaging: the emergence of speckle tracking echocardiography into clinical pediatric cardiology. Congenit Heart Dis 2016; 11: 199–208.Google Scholar
34. Eidem, BW, McMahon, CJ, Cohen, RR, et al. Impact of cardiac growth on Doppler tissue ımaging velocities: a study in healthy children. J Am Soc Echocardiogr 2004; 17: 212–221.Google Scholar
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