Liu Kaiwei, Yu Jiahui, Song Guang
Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.
Front Pediatr. 2022 Jun 27;10:848306. doi: 10.3389/fped.2022.848306. eCollection 2022.
Nearly 6,000 multisystem inflammatory syndrome in children (MIS-C) have been reported in the United States by November 2021. Left ventricular global myocardial strain has been proved to be one of the best evidence of the diagnostic and prognostic implications for cardiac dysfunction. The global myocardial strain change of MIS-C in the acute phase was still unclear.
PubMed and other sources were searched. A network meta-analysis was conducted. MIS-C was divided into two groups according to left ventricular ejection fraction (LVEF): MIS-C with depressed ejection fraction (MIS-C dEF) and MIS-C with preserved ejection fraction (MIS-C pEF). Global longitudinal strain (GLS) and global circumferential strain (GCS) were compared among MIS-C, Kawasaki disease (KD), and healthy children.
In total, nine case-control studies were included, published between 2014 and 2021. These studies involved 107 patients with MIS-C, 188 patients with KD, and 356 healthy children. After Bayesian analysis, MIS-C dEF group was found to have a lower LVEF, higher GLS and GCS than the KD groups. Both MIS-C pEF and KD had similar GLS and GCS, which were higher than healthy controls. There was no difference of LVEF among MIS-C pEF, KD, and healthy controls.
MIS-C dEF was more severe than KD, both in LVEF and global myocardial strain. MIS-C pEF and KD were similar with mild impaired left ventricular myocardial strain compared with the healthy children. Global myocardial strain may be a monitoring index for MIS-C.
[https://www.crd.york.ac.uk/prospero/], identifier [CRD42021264760].
截至2021年11月，美国已报告近6000例儿童多系统炎症综合征（MIS-C）。左心室整体心肌应变已被证明是对心脏功能障碍进行诊断和预后评估的最佳证据之一。MIS-C急性期的整体心肌应变变化仍不明确。
检索了PubMed等资源。进行了一项网状荟萃分析。根据左心室射血分数（LVEF）将MIS-C分为两组：射血分数降低的MIS-C（MIS-C dEF）和射血分数保留的MIS-C（MIS-C pEF）。比较了MIS-C、川崎病（KD）和健康儿童的整体纵向应变（GLS）和整体圆周应变（GCS）。
总共纳入了9项病例对照研究，发表于2014年至2021年之间。这些研究涉及107例MIS-C患者、188例KD患者和356名健康儿童。经过贝叶斯分析，发现MIS-C dEF组的LVEF较低，GLS和GCS高于KD组。MIS-C pEF和KD的GLS和GCS相似，均高于健康对照组。MIS-C pEF、KD和健康对照组之间的LVEF没有差异。
在LVEF和整体心肌应变方面，MIS-C dEF比KD更严重。与健康儿童相比，MIS-C pEF和KD的左心室心肌应变轻度受损且相似。整体心肌应变可能是MIS-C的一个监测指标。
