Suzuki A, Kamiya T, Tsuchiya K, Sato I, Arakaki Y, Kohata T, Ono Y
Department of Pediatrics, National Cardiovascular Center, Osaka, Japan.
Am J Cardiol. 1988 Feb 1;61(4):386-90. doi: 10.1016/0002-9149(88)90950-2.
Valvular lesions in the acute phase of Kawasaki disease were studied in 19 children. The patients were intensively observed by color flow Doppler every day from the day of hospitalization up to 12 days after the onset of the disease and 2 or more times a week thereafter, for up to 28 days. Mitral regurgitation (MR) was found in 9 patients (47%) and tricuspid regurgitation (TR) in 10 (53%). MRs were of transient type and confirmed from 7.5 +/- 1.6 (mean +/- standard deviation) to 13.1 +/- 6.5 days after the onset of the disease. Both types of valvular regurgitation were mild. The direction of regurgitation was from the center of valvular coaptation toward the posterior wall of the atrium. Neither valvular prolapse nor valvular deformity was noted. In patients with MR, left ventricular ejection fraction on M-mode echocardiography was significantly lower in the acute phase than in the convalescent phase of the disease (p less than 0.05). Using gallium-67 scintigram, the positive uptake of the isotope was noted in 7 (88%) of 8 patients with MR, but not found at all in 8 patients free of MR. These results suggest that MR and TR are often transient in the acute phase of Kawasaki disease and could be attributed to myocarditis.
对19名川崎病急性期的瓣膜病变患儿进行了研究。从住院日起至发病后12天，每天用彩色多普勒对患者进行密切观察，此后每周观察2次或更多次，观察期长达28天。9例（47%）患者发现二尖瓣反流（MR），10例（53%）患者发现三尖瓣反流（TR）。MR为短暂性，在发病后7.5±1.6（平均±标准差）至13.1±6.5天得到证实。两种瓣膜反流均为轻度。反流方向是从瓣膜贴合中心朝向心房后壁。未发现瓣膜脱垂或瓣膜畸形。在有MR的患者中，M型超声心动图显示急性期左心室射血分数显著低于疾病恢复期（p<0.05）。使用镓-67闪烁扫描，8例有MR的患者中有7例（88%）发现同位素摄取阳性，而8例无MR的患者中均未发现。这些结果表明，MR和TR在川崎病急性期通常是短暂的，可能归因于心肌炎。
