Key result
Lower GLS in Kawasaki disease correlates strongly with elevated fibrosis marker PIIINP.
Why the study?
Whether Kawasaki disease-induced myocardial lesions can be detected earlier using two-dimensional speckle tracking echocardiography in late convalescent phase patients is not well explored.
Can two-dimensional speckle tracking echocardiography (2DSTE) detect subclinical myocardial dysfunction in mid-term follow-up Kawasaki disease patients?
Case-Control (n=128)
Can two-dimensional speckle tracking echocardiography (2DSTE) detect subclinical myocardial dysfunction in mid-term follow-up Kawasaki disease patients?
Two-dimensional speckle tracking echocardiography can detect subclinical myocardial dysfunction and fibrosis in mid-term follow-up Kawasaki disease patients despite normal conventional echocardiography.
Answers are grounded in this paper and cite their sources.
May support 2DSTE for subclinical dysfunction detection in Kawasaki disease; hypothesis-generating and requires prospective validation.
BACKGROUND: Myocardial impairment proved by histological studies persists in late convalescent phase Kawasaki disease patients. Whether Kawasaki disease-induced myocardial lesions can be detected in an earlier time is not well explored. In this study, we aimed to evaluate left ventricular (LV) myocardial function by two dimensional speckle tracking echocardiography (2DSTE) in late convalescent phase Kawasaki disease patients. METHODS: A total of 68 Kawasaki disease patients during mid-term phase including 47 with no coronary artery aneurysm (NCAA) and 21 with coronary artery aneurysm (CAA), and 60 controls with age matched were consecutively enrolled. RESULTS: No significant differences on conventional echocardiographic LV systolic function indices were found among group comparison. Compared with controls, Kawasaki disease patients had lower global longitudinal stain (GLS) and global circumferential stain (GCS). In subgroup analysis, both those with CAA and without CAA had lower GLS, lower GCS, higher amino-terminal propeptide of type III procollagen (PIIINP) and higher carboxyterminal propeptide of procollagen type I (PIPC) than in controls. GLS had significantly negative correlations with PIIINP (r = -0.69, P = 0.002) and PIPC (r = -0.82, P = 0.000). CONCLUSION: Subclinical myocardial dysfunction in mid-term follow-up Kawasaki disease patients existed regardless of coronary artery status despite normal measurements of LV systolic function by routine echocardiography, and myocardial fibrosis may play a contributed role in this subclinical myocardial function impairment. 2DSTE is a valuable imaging modality for detecting regional and global myocardial dysfunction in Kawasaki disease patients in an early time.
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Wang et al. (2020) conducted a case-control in Kawasaki disease (n=128). Two-dimensional speckle tracking echocardiography (2DSTE) vs. Age-matched controls was evaluated on Left ventricular myocardial function assessed by global longitudinal strain (GLS) and global circumferential strain (GCS). Two-dimensional speckle tracking echocardiography detected lower global longitudinal strain in Kawasaki disease patients, which correlated negatively with fibrosis marker PIIINP (r=-0.69, P=0.002).
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