Echocardiographic Evaluation of Left Ventricular Function in Kawasaki Disease: Effect of Immune Globulin

Jung, Mi Jin

Abstract

PURPOSE
The purpose of this investigation was to identify the impaired myocardial function and improvement with immune globulin in Kawasaki disease.
METHODS
The myocardial performance and diastolic function were evaluated in 52 patients. M-mode and Doppler echocardiography were performed before(pre) and after immune globulin treatment:two to nine days(pre), five to 15 days(period one), 14 to 35 days(period two), 49 to 77 days(period three) from onset, respectively.
RESULTS
Myocardial performance of the patients compared to normal controls by fractional shortening(mean 33.6% vs 35.6%:P=0.07) and Tei index(mean 0.49 vs 0.47, P=0.1) was reduced at present, and improved after immune globulin(34.7%, 0.47 respectively), but was statistically not significant. Doppler echocardiography showed decreased isovolumic relaxation time(mean 38 ms vs 49 ms, P< 0.001), deceleration time(mean 72 ms vs 87 ms, P<0.001) and pulmonary vein S and D velocity time integral ratio(1.46 vs 1.66, P=0.1). Only IVRT showed significant differences after immune globulin (38-49-49-49 ms, P<0.001).
CONCLUSION
I conclude that patients with Kawasaki disease exhibit decreased myocardial performance at present and improvement after immune globulin treatment, but it is not as peculiar as the published reports. The diastolic function assessed by Doppler echocardiography shows similar features to the restrictive pattern of diastolic dysfunction, but needs to be compared with febrile controls to determine.