Left ventricular mechanics in patients with a history of Kawasaki Disease: analysis by 3-dimensional speckle tracking echocardiography

Abstract

Background Myocardial fi brosis and perfusion abnormalities suggestive of myocardial ischemia can occur in patients with a history of Kawasaki disease (KD). We tested the hypothesis that children and adolescents with a history of KD have long-term abnormalities in left ventricular (LV) mechanics. Methods 14 KD patients (10 males), aged 18.0 ± 5.7 years, with coronary aneurysms were studied using a novel 3D speckle tracking echocardiography technique. The 3D volume datasets were acquired for quantifi cation of LV global 3D strain, systolic dyssynchrony index (SDI), twist, twist gradient (twist/LV length), and ejection fraction. The results were compared with those of 14 age-matched controls. Results Of the 14 patients, 6 had left, 2 had right, and 6 had both left and right coronary aneurysms. As compared with controls, patients had signifi cantly lower LV systolic global 3D strain (43.7 ± 7.3% vs 49.7 ± 7.6%, p = 0.04), twist (8.7 ± 1.3 deg vs 11.4 ± 2.0 deg, p < 0.001), and twist gradient (1.5 ± 0.3 deg/ cm vs 1.9 ± 0.4 deg/cm, p = 0.01), greater SDI (6.8 ± 1.9% vs 5.4 ± 1.1%, p = 0.03), and similar ejection fractions. Five patients had perfusion defects, but the parameters of 3D LV mechanics among these patients were similar to those of the 9 patients without perfusion abnormalities. Conclusions Late abnormalities of LV mechanics occur in KD patients with coronary aneurysms, even in the absence of perfusion abnormalities.