Cardiac magnetic resonance feature tracking in Kawasaki disease convalescence.
Cardiac magnetic resonance feature tracking in Kawasaki disease convalescence.
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DOI：
10.4103/0974-2069.197046
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发表时间：
2017-01
影响因子：
0.7
通讯作者：
Greil G
中科院分区：
文献类型：
--
作者：
Bratis K;Hachmann P;Child N;Krasemann T;Hussain T;Mavrogeni S;Botnar R;Razavi R;Greil G
本研究的目的是确定左心室（LV）心肌变形指数是否可以检测出川崎恢复期的亚临床异常。我们假设炎症引起的亚临床心肌异常是疾病的早期表现，在恢复期持续存在。心肌炎症被描述为川崎急性期的一个全球性发现。尽管常规功能测量显示收缩功能正常，但在急性期超声心动图检测到纵向应变和应变率降低。对29例川崎恢复期患者左室收缩期峰值心肌纵向、径向和周向应变及应变率进行了检测（15名男性;平均[标准差]年龄：11 [6.6]岁;疾病发作的中位间隔：5.8 [5.4]年）和10名健康志愿者（5名男性;平均年龄：14 [3.8]岁），使用心脏磁共振（CMR）特征跟踪。两组左室收缩功能常规指标均正常。比较正常对照组和（i）整个川崎病组，（ii）按冠状动脉受累划分的川崎病亚组。与正常对照组相比，患者所有水平的平均纵向和周向应变均较低。在亚组分析中，有和无冠状动脉受累史的川崎患者在所有节段的纵向和周向应变相似，与对照组相比更低。冠状动脉持续病变的川崎患者的周向和纵向值低于冠状动脉消退的患者。在这项保留常规功能指标的川崎病恢复期患者的CMR研究中，我们检测到与正常对照组相比较低的周向和纵向应变值，与冠状动脉状态无关。
The objective of this study was to determine whether left ventricular (LV) myocardial deformation indices can detect subclinical abnormalities in Kawasaki disease convalescence. We hypothesized that subclinical myocardial abnormalities due to inflammation represent an early manifestation of the disease that persists in convalescence. Myocardial inflammation has been described as a global finding in the acute phase of Kawasaki disease. Despite normal systolic function by routine functional measurements, reduced longitudinal strain and strain rate have been detected by echocardiography in the acute phase. Peak systolic LV myocardial longitudinal, radial, and circumferential strain and strain rate were examined in 29 Kawasaki disease convalescent patients (15 males; mean [standard deviation] age: 11 [6.6] years; median interval from disease onset: 5.8 [5.4] years) and 10 healthy volunteers (5 males; mean age: 14 [3.8] years) with the use of cardiac magnetic resonance (CMR) feature tracking. Routine indices of LV systolic function were normal in both groups. Comparisons were made between normal controls and (i) the entire Kawasaki disease group, (ii) Kawasaki disease subgroup divided by coronary artery involvement. Average longitudinal and circumferential strain at all levels was lower in patients compared to normal controls. In subgroup analysis, both Kawasaki disease patients with and without a history of coronary involvement had similar longitudinal and circumferential strain at all levels and lower when compared to controls. There were lower circumferential and longitudinal values in Kawasaki disease patients with persisting coronary artery lesions when compared to those with regressed ones. In this CMR study in Kawasaki disease convalescent patients with preserved routine functional indices, we detected lower circumferential and longitudinal strain values compared to normal controls, irrespective of the coronary artery status.