Azak Emine, Cetin Ibrahim Ilker, Gursu Hazım A, Kibar Ayse Esin, Surucu Murat, Orgun Ali, Pamuk Utku
Department of Pediatric Cardiology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey.
Echocardiography. 2018 Mar;35(3):380-387. doi: 10.1111/echo.13773. Epub 2017 Dec 13.
To investigate myocardial deformation and function during treatment for Kawasaki disease (KD) in children.
We performed speckle tracking echocardiography (STE) and tissue Doppler imaging (TDI) in 15 children with KD and 15 healthy children during treatment for KD. STE was performed for longitudinal and circumferential strain (S) and strain rate (SR) at the left ventricle (LV) and for longitudinal S and SR at the right ventricle (RV). TDI was performed at the base of interventricular septum (IVS), LV, and RV.
Among TDI parameters, E and ejection time (ET) at IVS, ET at LV and ET at RV obtained obtained before treatment were significantly lower in patients with KD compared to controls. After treatment, in spite of improvements, ET at IVS and ET at RV remained significantly lower in patients with KD compared to controls. Left ventricular global longitudinal and circumferential S and SR values obtained before treatment were significantly lower in patients with KD compared to controls. Left ventricular S and SR values were found to be increased after treatment. However, left ventricular global circumferential S value remained significantly lower in patients with KD compared to controls. There were no significant differences in right ventricular global longitudinal S and SR values between patients and controls before treatment.
During acute phase, patients with KD have reduced global left ventricular S and SR which may be more sensitive indicators of myocardial inflammation. This study showed gradual improvements in left ventricular myocardial function during treatment for KD.
研究儿童川崎病（KD）治疗期间的心肌变形和功能。
我们对15例KD患儿和15例健康儿童在KD治疗期间进行了斑点追踪超声心动图（STE）和组织多普勒成像（TDI）检查。STE测量左心室（LV）的纵向和圆周应变（S）及应变率（SR），以及右心室（RV）的纵向S和SR。TDI在室间隔（IVS）基部、LV和RV进行。
在TDI参数中，KD患者治疗前IVS处的E和射血时间（ET）、LV处的ET以及RV处的ET均显著低于对照组。治疗后，尽管有所改善，但KD患者IVS处的ET和RV处的ET仍显著低于对照组。KD患者治疗前获得的左心室整体纵向和圆周S及SR值显著低于对照组。治疗后左心室S和SR值升高。然而，KD患者左心室整体圆周S值仍显著低于对照组。治疗前患者与对照组右心室整体纵向S和SR值无显著差异。
在急性期，KD患者左心室整体S和SR降低，这可能是心肌炎症更敏感的指标。本研究显示KD治疗期间左心室心肌功能逐渐改善。
