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Evaluation of longitudinal and radial left ventricular functions on 2‐D and 3‐D echocardiography before and after intravenous immunoglobulin in acute Kawasaki disease
Author(s) -
Hashimoto Ikuo,
Saitou Yu,
Sakata Nao,
Shibata Ko
Publication year - 2017
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13423
Subject(s) - medicine , ejection fraction , cardiology , kawasaki disease , brain natriuretic peptide , ventricular function , stroke volume , heart failure , artery
Background The relationship between left ventricular (LV) function and longitudinal or radial contraction has not yet been elucidated in acute Kawasaki disease (KD), especially before and after treatment with intravenous immunoglobulin (IVIG). Methods We studied 28 KD patients without coronary aneurysms (average age, 3.2 years). The LV end‐diastolic volume (LVEDV), end‐systolic volume (LVESV), stroke volume (LVSV), and ejection fraction (LVEF) were assessed on 3‐D echocardiography before IVIG, after IVIG, and in the convalescent phase. LV fractional shortening (LVFS) and the mitral annular plane systolic excursion (MAPSE) z ‐score were measured as surrogates for radial and longitudinal LV wall motions, respectively. Serum brain natriuretic peptide (BNP) was also assessed as a heart failure indicator in acute KD patients. Results In all KD patients, LVEDV decreased in the acute phase with preservation of LVESV. Both LVSV and MAPSE z ‐score were lowest before IVIG and increased after IVIG. MAPSE z ‐score was highly correlated with LVEF before and after IVIG treatment. Although there was a good correlation between logBNP and LVEF before IVIG, it was lost after IVIG. Conclusions LVEDV decreased longitudinally during the acute phase of KD with preservation of LVESV, reducing both LVSV and LVEF. Serum BNP is a useful marker for evaluating LV function only prior to IVIG treatment.