Assessment of Left Ventricular Function in Kawasaki Disease by Tissue Doppler Echocardiography

Shin, Jee Seon; Choi, Hi Jung; Hong, Young Mi

Abstract

PURPOSE
Tissue Doppler Imaging(TDI) is a modern echocardiographic technique used for quantitative assessment of myocardial tissue velocities. The purpose of this study is to estimate the left ventricular function by TDI in Kawasaki disease(KD).
METHODS
TDI and conventional echocardiography were performed in 33 patients(3.2+/-2.4 years) in acute phase, 33 patients(4.2+/-4.0 years) in subacute phase of KD and 60 children(5.4+/-3.9 years) in controls. Systolic velocity, systolic integral, E' velocity, E' integral, A' velocity and A' integral at the base, mid-septum and the apex were measured. Ejection fraction(EF) and myocardial performance index(MPI) were estimated by conventional echocardiography. Myocardial function was compared in KD patients of the acute and subacute phase with controls by TDI and conventional echocardiography.
RESULTS
E' integral at the base(4.59+/-3.87 cm vs 6.91+/-4.29 cm, P<0.05), mid septum(3.52+/-3.13 cm vs 5.49+/-3.47 cm, P<0.05), apex(2.52+/-2.40 cm vs 3.80+/-2.48 cm, P<0.05), A' integral at the mid septum(1.24+/-1.19 cm vs 2.11+/-1.64 cm, P<0.05) and apex(1.14+/-1.32 cm vs 1.90+/-1.59 cm, P<0.05) were lower in the acute phase patients than in the controls. Systolic integral at base, mid septum and apex were significantly lower in KD patients of the acute phase than in the controls. There was significant negative correlation with right coronary artery diameter and systolic integral, E' integral, A' integral at mid septum, E' integral, A' integral at apex in the acute phase of KD. EF and MPI were not significantly decreased in KD.
CONCLUSION
Myocardial velocity was not different, but systolic and diastolic integrals at the left ventricular septum were significantly decreased in the acute phase of KD by TDI. The data will need to be compared with febrile controls.