Evaluation of myocardial deformation in children with Kawasaki disease by two dimensional speckle tracking echocardiography

Objective To investigate and assess the diagnostic value of left ventricular myocardial deformation during different phases of Kawasaki disease(KD)by two-dimensional speckle tracking echocardiography. Methods A total of 91 patients with KD were recruited as the research group, which was divided into acute phase group(A), convalescent phase group(B)and chronic phase group(C). Based on whether occuring coronary artery lesions, the acute phase group was then subdivided.Meanwhile 56 healthy subjects were recruited as control group.Two-dimensional echocardiography was applied for collecting all myocardial motion images.Left ventricular ejection fraction(LVEF), left ventricular fractional shortening(LVFS)and other indexes were analyzed by traditional echocardiography and tissue Doppler image.Global longitudinal strain(GLS), strain rate(GLSR)and circumferential strain(GCS), strain rate(GCSR)were calculated via QLAB 9.0 software offline. Results Firstly, no significant difference was found in parameters by conventional echocardiography, i.e.LVEF and LVFS among three groups.Secondly, compared with the control group, the GLS of group A and group C were significantly reduced(P<0.01). The GCS and GCSR of each group were significantly lower than that in the control group(P<0.01). The GCSR of three groups decreased significantly, but the difference among three groups was significant(P<0.01). Thirdly, The indexes of GLS, GLSR, GCS and GCSR were significantly reduced in coronary artery lesions subgroup than that of coronary artery without injury subgroup.Lastly, the results of DTI image showed that lateral wall myocardial early diastolic velocity of group B was higher than A and C(P<0.05)among the research groups.Septum myocardial systolic velocity of group A and C were significantly lower than the control group(P<0.05). Conclusion Firstly, myocardial damage happened in varying degrees at different phases of KD.Meanwhile, coronary artery lesions of KD may do harm to myocardial function.Last but not least, two-dimensional speckle tracking echocardiography is an effective way to evaluate the subclinical cardiac dysfunction of KD.