Key result
Three-dimensional speckle tracking echocardiography revealed impaired LV mechanics in Kawasaki disease patients with coronary aneurysms, including lower global 3D strain (43.7% vs 50.4%, P=0.02).
Why the study?
Does three-dimensional speckle tracking echocardiography detect impaired left ventricular mechanics in adolescents and young adults with a history of Kawasaki disease compared to healthy controls?
Cross-Sectional (n=39)
Does three-dimensional speckle tracking echocardiography detect impaired left ventricular mechanics in adolescents and young adults with a history of Kawasaki disease compared to healthy controls?
Three-dimensional speckle tracking echocardiography reveals subclinical impairment of left ventricular mechanics in adolescents and young adults with a history of Kawasaki disease, particularly those with coronary aneurysms.
Answers are grounded in this paper and cite their sources.
May support 3D STE for subclinical LV monitoring in Kawasaki disease; leaves open prospective validation before practice change.
BACKGROUND: Myocardial fibrosis and perfusion abnormalities can occur in patients with Kawasaki disease (KD). We explored using the new three-dimensional speckle tracking echocardiography (3DSTE) the left ventricular (LV) mechanics in adolescents and young adults with a history of KD. METHODS: Twenty-five KD patients (18 males) aged 17.0 ± 5.2 years, 14 with (group I) and 11 without (group II) coronary aneurysms, were studied. The 3D volume datasets were acquired for quantification of LV global 3D strain, global and regional area strain, systolic dyssynchrony index (SDI), twist, twist gradient (twist/LV length), and ejection fraction. RESULTS: The results were compared with those of 14 age-matched controls. Of the 14 group I patients, 6 had left, 2 had right, and 6 had both left and right coronary aneurysms. Compared with controls, group I patients had significantly lower LV systolic global 3D strain (43.7 ± 7.3% vs. 50.4 ± 6.6%, P = 0.02), twist (8.7 ± 1.3° vs. 11.4 ± 2.0°, P < 0.001), and twist gradient (1.5 ± 0.3°/cm vs. 1.9 ± 0.4°/cm, P = 0.01), greater SDI (6.8 ± 1.9% vs. 4.7 ± 1.9%, P < 0.001), and similar ejection fractions. Six patients in group I had perfusion defects, who had global 3DSTE parameters similar to those of the 8 patients without perfusion abnormalities (all P > 0.05). For group II patients, only the global area strain was significantly lower than that of controls (37.6 ± 3.5% vs. 40.7 ± 3.6%, P = 0.038). CONCLUSION: In adolescents and young adults with a history of KD, impairment of LV mechanics occurs and is worse in patients with than those without coronary complications.
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Yu et al. (2013) conducted a cross-sectional in Kawasaki disease (n=39). Three-dimensional speckle tracking echocardiography (3DSTE) vs. Age-matched controls was evaluated on Left ventricular systolic global 3D strain (p=0.02). Three-dimensional speckle tracking echocardiography revealed impaired LV mechanics in Kawasaki disease patients with coronary aneurysms, including lower global 3D strain (43.7% vs 50.4%, P=0.02).
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