Lang Sean M, Truong Dongngan T, Powell Andrew J, Kazlova Valiantsina, Newburger Jane W, Awerbach Jordan D, Binka Edem, Bradford Tamara T, Cartoski Mark, Cheng Andrew, DiLorenzo Michael P, Dionne Audrey, Dorfman Adam L, Elias Matthew D, Garuba Olukayode, Gerardin Jennifer F, Hasbani Keren, Jone Pei-Ni, Lam Christopher Z, Misra Nilanjana, Morgan Lerraughn M, Nutting Arni, Patel Jyoti K, Robinson Joshua D, Schuchardt Eleanor L, Sexson Tejtel Kristen, Singh Gautam K, Slesnick Timothy C, Trachtenberg Felicia, Taylor Michael D
Heart Institute, Cincinnati Children's Hospital Medical Center, OH (S.M.L., M.D.T.).
Department of Pediatrics, Division of Cardiology, University of Utah and Primary Children's Hospital, Salt Lake City (D.T.T., E.B.).
Circ Cardiovasc Imaging. 2025 Apr 4:e017420. doi: 10.1161/CIRCIMAGING.124.017420.
Multisystem Inflammatory Syndrome in Children is characterized by high rates of acute cardiovascular involvement with rapid recovery of organ dysfunction. However, information regarding long-term sequelae is lacking. We sought to characterize the systolic function and myocardial tissue properties using cardiac magnetic resonance (CMR) imaging in a multicenter observational cohort of Multisystem Inflammatory Syndrome in Children patients.
In this observational cohort study, comprising 32 centers in North America, CMR studies were analyzed by a core laboratory to assess ventricular volumetric data, tissue characterization, and coronary involvement.
A total of 263 CMRs from 255 Multisystem Inflammatory Syndrome in Children patients were analyzed. The mean patient age was 11.4±4.4 years. Most studies were performed at 3 months (33%) or 6 months (45%) after hospitalization. Left ventricular dysfunction was present in 17 (6.7%) of the first CMRs and was never worse than mild. Dysfunction was observed in 4/7 (57%) patients at admission, 5/87 (6.9%) patients at 3 months, and 6/129 (4.6%) patients imaged either at 6 months or 1 year post-hospitalization. Late gadolinium enhancement was present in 2 (0.8%) patients, 1 at 3 months and another at 6 months following hospitalization. Coronary artery dilation was present in 13 of the 174 (7.5%) patients. Nine patients met the Lake Louise criteria for myocarditis (3.5%) at the time of CMR.
In this largest published multiinstitutional longitudinal CMR evaluation of confirmed Multisystem Inflammatory Syndrome in Children patients, the prevalence of ventricular dysfunction and myocardial tissue characterization abnormalities on medium-term follow-up was low. However, a small number of patients had mild residual abnormalities at 6 months and 1 year following hospitalization.
URL: https://www.clinicaltrials.gov; Unique identifier: NCT05287412.
儿童多系统炎症综合征的特征是急性心血管受累发生率高，器官功能障碍能迅速恢复。然而，关于长期后遗症的信息尚缺。我们试图在一个儿童多系统炎症综合征患者的多中心观察队列中，使用心脏磁共振成像（CMR）来描述收缩功能和心肌组织特性。
在这项观察性队列研究中，纳入了北美32个中心，核心实验室对CMR研究进行分析，以评估心室容积数据、组织特征和冠状动脉受累情况。
共分析了255例儿童多系统炎症综合征患者的263次CMR检查结果。患者的平均年龄为11.4±4.4岁。大多数检查在住院后3个月（33%）或6个月（45%）进行。首次CMR检查时，17例（6.7%）存在左心室功能障碍，且从未超过轻度。入院时4/7（57%）的患者出现功能障碍，3个月时5/87（6.9%）的患者出现功能障碍，住院后6个月或1年成像时6/129（4.6%）的患者出现功能障碍。2例（0.8%）患者出现延迟钆增强，1例在住院后3个月，另1例在6个月。174例患者中有13例（7.5%）出现冠状动脉扩张。9例患者在CMR检查时符合心肌炎的路易斯湖标准（3.5%）。
在这项已发表的关于确诊儿童多系统炎症综合征患者的最大规模多机构纵向CMR评估中，中期随访中心室功能障碍和心肌组织特征异常的发生率较低。然而，少数患者在住院后6个月和1年时有轻度残留异常。
