J Cardiovasc Ultrasound.  2018 Mar;26(1):26-32. 10.4250/jcu.2018.26.1.26.

Long Term Outcomes of Left Atrial Reservoir Function in Children with a History of Kawasaki Disease

Affiliations
  • 1Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea. kittysooni@chamc.co.kr
  • 2Department of Diagnostic Laboratory Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.

Abstract

BACKGROUND
Decreased left atrial (LA) reservoir function is reported to be associated with elevated left ventricular (LV) end diastolic pressure and LV diastolic dysfunction. Echocardiographic parameters that reflect LA reservoir function include LA total emptying fraction [(maximum LA volume - minimum LA volume) / maximum LA volume], peak LA longitudinal strain (PLALS) at systole, and LA stiffness index (E/E´/PLALS). We aimed to investigate the long-term outcomes of LV diastolic function in children with a history of Kawasaki disease (KD) (KDHx group) by assessing LA reservoir function.
METHODS
Retrospectively, echocardiograms performed at a mean follow-up period of 5 years after the acute phase of KD in 24 children in the KDHx group were compared to those from 20 normal control subjects. LA total emptying fraction, PLALS, LA stiffness index, LV peak longitudinal systolic strain (ε), and strain rate (SR) were evaluated with conventional echocardiographic parameters.
RESULTS
The mean age at long term follow-up echocardiography in children in the KDHx group was 6.8 years. Five children (20.8%) had coronary artery lesions (CALs) in the acute stage of KD. No children showed CALs at a mean follow-up period of 5 years after the acute phase of KD. There were no significant differences in the conventional echocardiographic parameters and in LA total emptying fraction, PLALS, LA stiffness index, LV peak longitudinal systolic ε, and SR, between the children in the KDHx and control group.
CONCLUSION
LV diastolic function assessed by LA reservoir function parameters at long-term follow-up in children in the KDHx group appears to be favorable.

Keyword

Kawasaki disease; Atrial function; Long term; Prognosis

MeSH Terms

Atrial Function
Blood Pressure
Child*
Coronary Vessels
Echocardiography
Follow-Up Studies
Humans
Mucocutaneous Lymph Node Syndrome*
Prognosis
Retrospective Studies
Systole

Figure

  • Fig. 1 Peak left atrial longitudinal strain (PLALS) at systole. A: Example of PLALS at systole by velocity vector imaging at long-term follow-up of a child with a history of Kawasaki disease. B: The average of PLALS from 3 atrial segments (interatrial septum, roof, and lateral wall) is shown.


Cited by  1 articles

Sequential Changes in Left Ventricular Systolic Myocardial Deformation Mechanics in Children with Recurrent Kawasaki Disease
Soo Jung Kang, Bo Kyeong Jin, Seo Jung Hwang, Hyo Jin Kim
J Cardiovasc Imaging. 2018;26(3):147-154.    doi: 10.4250/jcvi.2018.26.e12.


Reference

1. Takeuchi D, Saji T, Takatsuki S, Fujiwara M. Abnormal tissue doppler images are associated with elevated plasma brain natriuretic peptide and increased oxidative stress in acute Kawasaki disease. Circ J. 2007; 71:357–362. PMID: 17322635.
2. Kurotobi S, Kawakami N, Shimizu K, Aoki H, Nasuno S, Takahashi K, Kogaki S, Ozono K. Brain natriuretic peptide as a hormonal marker of ventricular diastolic dysfunction in children with Kawasaki disease. Pediatr Cardiol. 2005; 26:425–430. PMID: 15633045.
3. Kang SJ, Kwon YW, Hwang SJ, Kim HJ, Jin BK, Yon DK. Clinical utility of left atrial strain in children in the acute phase of Kawasaki disease. J Am Soc Echocardiogr. 2018; 31:323–332. PMID: 29305035.
4. Selamet Tierney ES, Newburger JW, Graham D, Baker A, Fulton DR, Colan SD. Diastolic function in children with Kawasaki disease. Int J Cardiol. 2011; 148:309–312. PMID: 19945179.
5. Dandel M, Hetzer R. Echocardiographic strain and strain rate imaging--clinical applications. Int J Cardiol. 2009; 132:11–24. PMID: 18760848.
6. D'hooge J, Heimdal A, Jamal F, Kukulski T, Bijnens B, Rademakers F, Hatle L, Suetens P, Sutherland GR. Regional strain and strain rate measurements by cardiac ultrasound: principles, implementation and limitations. Eur J Echocardiogr. 2000; 1:154–170. PMID: 11916589.
7. Otani K, Takeuchi M, Kaku K, Haruki N, Yoshitani H, Tamura M, Abe H, Okazaki M, Ota T, Lang RM, Otsuji Y. Impact of diastolic dysfunction grade on left atrial mechanics assessed by two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogr. 2010; 23:961–967. PMID: 20667694.
8. Blume GG, Mcleod CJ, Barnes ME, Seward JB, Pellikka PA, Bastiansen PM, Tsang TS. Left atrial function: physiology, assessment, and clinical implications. Eur J Echocardiogr. 2011; 12:421–430. PMID: 21565866.
9. Wakami K, Ohte N, Asada K, Fukuta H, Goto T, Mukai S, Narita H, Kimura G. Correlation between left ventricular end-diastolic pressure and peak left atrial wall strain during left ventricular systole. J Am Soc Echocardiogr. 2009; 22:847–851. PMID: 19560662.
10. Khurram IM, Maqbool F, Berger RD, Marine JE, Spragg DD, Ashikaga H, Zipunnikov V, Kass DA, Calkins H, Nazarian S, Zimmerman SL. Association between left atrial stiffness index and atrial fibrillation recurrence in patients undergoing left atrial ablation. Circ Arrhythm Electrophysiol. 2016; 9:e003163. PMID: 26966287.
11. Kurt M, Wang J, Torre-Amione G, Nagueh SF. Left atrial function in diastolic heart failure. Circ Cardiovasc Imaging. 2009; 2:10–15. PMID: 19808559.
12. Machino-Ohtsuka T, Seo Y, Tada H, Ishizu T, Machino T, Yamasaki H, Igarashi M, Xu D, Sekiguchi Y, Aonuma K. Left atrial stiffness relates to left ventricular diastolic dysfunction and recurrence after pulmonary vein isolation for atrial fibrillation. J Cardiovasc Electrophysiol. 2011; 22:999–1006. PMID: 21457382.
13. Barbier P, Solomon SB, Schiller NB, Glantz SA. Left atrial relaxation and left ventricular systolic function determine left atrial reservoir function. Circulation. 1999; 100:427–436. PMID: 10421605.
14. Posina K, McLaughlin J, Rhee P, Li L, Cheng J, Schapiro W, Gulotta RJ, Berke AD, Petrossian GA, Reichek N, Cao JJ. Relationship of phasic left atrial volume and emptying function to left ventricular filling pressure: a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson. 2013; 15:99. PMID: 24168103.
15. Kurt M, Tanboga IH, Aksakal E, Kaya A, Isik T, Ekinci M, Bilen E. Relation of left ventricular end-diastolic pressure and N-terminal pro-brain natriuretic peptide level with left atrial deformation parameters. Eur Heart J Cardiovasc Imaging. 2012; 13:524–530. PMID: 22166592.
16. Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, Shulman ST, Bolger AF, Ferrieri P, Baltimore RS, Wilson WR, Baddour LM, Levison ME, Pallasch TJ, Falace DA. Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki disease, council on Cardiovascular Disease in the Young, American Heart Association. Pediatrics. 2004; 114:1708–1733. PMID: 15574639.
17. Lai WW, Geva T, Shirali GS, Frommelt PC, Humes RA, Brook MM, Pignatelli RH, Rychik J. Task Force of the Pediatric Council of the American Society of Echocardiography. Pediatric Council of the American Society of Echocardiography. Guidelines and standards for performance of a pediatric echocardiogram: a report from the Task Force of the Pediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr. 2006; 19:1413–1430. PMID: 17138024.
18. McCrindle BW, Li JS, Minich LL, Colan SD, Atz AM, Takahashi M, Vetter VL, Gersony WM, Mitchell PD, Newburger JW. Pediatric Heart Network Investigators. Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements. Circulation. 2007; 116:174–179. PMID: 17576863.
19. Kim DG, Lee KJ, Lee S, Jeong SY, Lee YS, Choi YJ, Yoon HS, Kim JH, Jeong KT, Park SC, Park M. Feasibility of two-dimensional global longitudinal strain and strain rate imaging for the assessment of left atrial function: a study in subjects with a low probability of cardiovascular disease and normal exercise capacity. Echocardiography. 2009; 26:1179–1187. PMID: 19725856.
20. Jarnert C, Melcher A, Caidahl K, Persson H, Rydén L, Eriksson MJ. Left atrial velocity vector imaging for the detection and quantification of left ventricular diastolic function in type 2 diabetes. Eur J Heart Fail. 2008; 10:1080–1087. PMID: 18838296.
21. Mor-Avi V, Lang RM, Badano LP, Belohlavek M, Cardim NM, Derumeaux G, Galderisi M, Marwick T, Nagueh SF, Sengupta PP, Sicari R, Smiseth OA, Smulevitz B, Takeuchi M, Thomas JD, Vannan M, Voigt JU, Zamorano JL. Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography. J Am Soc Echocardiogr. 2011; 24:277–313. PMID: 21338865.
22. Kutty S, Padiyath A, Li L, Peng Q, Rangamani S, Schuster A, Danford DA. Functional maturation of left and right atrial systolic and diastolic performance in infants, children, and adolescents. J Am Soc Echocardiogr. 2013; 26:398–409.e2. PMID: 23337737.
23. Levy PT, Machefsky A, Sanchez AA, Patel MD, Rogal S, Fowler S, Yaeger L, Hardi A, Holland MR, Hamvas A, Singh GK. Reference ranges of left ventricular strain measures by two-dimensional speckle-tracking echocardiography in children: a systematic review and meta-analysis. J Am Soc Echocardiogr. 2016; 29:209–225.e6. PMID: 26747685.
24. Bytyçi I, Bajraktari G, Ibrahimi P, Berisha G, Rexhepaj N, Henein MY. Left atrial emptying fraction predicts limited exercise performance in heart failure patients. Int J Cardiol Heart Vessel. 2014; 4:203–207. PMID: 29450190.
25. Moe GW, Grima EA, Angus C, Wong NL, Hu DC, Howard RJ, Armstrong PW. Response of atrial natriuretic factor to acute and chronic increases of atrial pressures in experimental heart failure in dogs. Role of changes in heart rate, atrial dimension, and cardiac tissue concentration. Circulation. 1991; 83:1780–1787. PMID: 1827057.
26. Cameli M, Sparla S, Losito M, Righini FM, Menci D, Lisi M, D'Ascenzi F, Focardi M, Favilli R, Pierli C, Fineschi M, Mondillo S. Correlation of left atrial strain and Doppler measurements with invasive measurement of left ventricular end-diastolic pressure in patients stratified for different values of ejection fraction. Echocardiography. 2016; 33:398–405. PMID: 26493278.
27. Perk G, Tunick PA, Kronzon I. Non-Doppler two-dimensional strain imaging by echocardiography--from technical considerations to clinical applications. J Am Soc Echocardiogr. 2007; 20:234–243. PMID: 17336748.
28. Hsiao SH, Huang WC, Lin KL, Chiou KR, Kuo FY, Lin SK, Cheng CC. Left atrial distensibility and left ventricular filling pressure in acute versus chronic severe mitral regurgitation. Am J Cardiol. 2010; 105:709–715. PMID: 20185021.
29. Arnold R, Goebel B, Ulmer HE, Gorenflo M, Poerner TC. An exercise tissue Doppler and strain rate imaging study of diastolic myocardial dysfunction after Kawasaki syndrome in childhood. Cardiol Young. 2007; 17:478–486. PMID: 17640399.
30. Muzik O, Paridon SM, Singh TP, Morrow WR, Dayanikli F, Di Carli MF. Quantification of myocardial blood flow and flow reserve in children with a history of Kawasaki disease and normal coronary arteries using positron emission tomography. J Am Coll Cardiol. 1996; 28:757–762. PMID: 8772768.
31. Hauser M, Bengel F, Kuehn A, Nekolla S, Kaemmerer H, Schwaiger M, Hess J. Myocardial blood flow and coronary flow reserve in children with “normal” epicardial coronary arteries after the onset of Kawasaki disease assessed by positron emission tomography. Pediatr Cardiol. 2004; 25:108–112. PMID: 14668960.
32. Yonesaka S, Takahashi T, Eto S, Sato T, Otani K, Ueda T, Sato A, Kitagawa Y, Konno Y, Kinjo M. Biopsy-proven myocardial sequels in Kawasaki disease with giant coronary aneurysms. Cardiol Young. 2010; 20:602–609. PMID: 20584347.
33. McCrindle BW, Rowley AH, Newburger JW, Burns JC, Bolger AF, Gewitz M, Baker AL, Jackson MA, Takahashi M, Shah PB, Kobayashi T, Wu MH, Saji TT, Pahl E. American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young. Council on Cardiovascular and Stroke Nursing. Council on Cardiovascular Surgery and Anesthesia. Council on Epidemiology and Prevention. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 2017; 135:e927–e999. PMID: 28356445.
34. Newburger JW, Sanders SP, Burns JC, Parness IA, Beiser AS, Colan SD. Left ventricular contractility and function in Kawasaki syndrome. Effect of intravenous gamma-globulin. Circulation. 1989; 79:1237–1246. PMID: 2720925.
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