Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2025-01-03T21:25:51.144Z Has data issue: false hasContentIssue false
  • English
  • Français

Elevation of the index of left ventricular mass during the acute and subacute phase of Kawasaki disease, and its association with indexes of diastolic function

Published online by Cambridge University Press:  02 December 2008

Jeong J. Yu ,
Byung O. Kwak ,
You H. Jeon ,
Yong-Mean Park ,
Ran Lee ,
Sochung Chung ,
Sun H. Bae  and
Bok Y. Pyun
Jeong J. Yu*
Affiliation:
Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea
Byung O. Kwak
Affiliation:
Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea
You H. Jeon
Affiliation:
Department of Pediatrics, Soonchunhyang University College of Medicine, Seoul, Korea
Yong-Mean Park
Affiliation:
Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea
Ran Lee
Affiliation:
Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea
Sochung Chung
Affiliation:
Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea
Sun H. Bae
Affiliation:
Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea
Bok Y. Pyun
Affiliation:
Department of Pediatrics, Soonchunhyang University College of Medicine, Seoul, Korea
*
Correspondence to: Jeong J. Yu, Department of Pediatrics, Konkuk University Hospital, 1, Hwayang-dong, Gwangjin-gu, Seoul 143-914, South Korea. Tel: 82-2-2030-7556; Mobile: 82-11-9869-8410; Fax: 82-2-2030-7749; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Our aim was to determine whether the index of left ventricular mass increases during the acute and subacute phase of Kawasaki disease, and to investigate any relationship between this index and clinical and echocardiographic variables. We performed, therefore, a retrospective study of 66 children with Kawasaki disease, having a mean age of 2.85 years, comparing the findings with those obtained from 57 normal controls, having a mean age of 2.99 years. The data from the patients used for comparison was obtained during the acute and subacute phase of the illness, as well as during the phase of convalescence. We performed correlation analysis of the findings during the acute and subacute phase, determining the relationship between the index of left ventricular mass and other variables. The index was higher (p = 0.0461), and the velocity of propagation of left ventricular early diastolic flow was lower (p < 0.0001), during the acute and subacute phase when compared to control values. The index then reduced (p = 0.0001) during the phase of convalescent when compared to the acute and subacute phase. Levels of albumin in the serum (p = 0.0193), peak E velocity (p = 0.0479), and velocity of propagation (p = 0.0360) were found to be related to the index of left ventricular mass. Significant relationships were found between the differences in this index and differences in body weight when findings during the acute and subacute phase were compared to those of the phase of convalescence. The index of left ventricular mass, therefore, is increased during the acute and subacute phase of Kawasaki disease, and is associated with altered diastolic indexes. This elevation may be due to generalized myocardial swelling from acute inflammation and increased vascular permeability. Measuring this index as a potential predictor of diastolic function should be added to studies of cardiac function during the acute and subacute phase of Kawasaki disease.

Keywords

Mucocutaneous lymph node syndromevascular permeabilitymyocarditis
Type
Original Article
Information
Cardiology in the Young , Volume 19 , Issue 1 , February 2009 , pp. 64 - 69
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Fujiwara, H, Hamashima, Y. Pathology of the heart in Kawasaki disease. Pediatrics 1978; 61: 100–107.CrossRefGoogle ScholarPubMed
2. Takahashi, M. Myocarditis in Kawasaki syndrome: a minor villain? Circulation 1989; 79: 1398–1400.CrossRefGoogle ScholarPubMed
3. Kurotobi, S, Kawakami, N, Shimizu, K, et al. Brain natriuretic peptide as a hormonal marker of ventricular diastolic dysfunction in children with Kawasaki disease. Pediatr Cardiol 2005; 26: 425–430.CrossRefGoogle ScholarPubMed
4. 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.CrossRefGoogle ScholarPubMed
5. Terai, M, Honda, T, Yasukawa, K, Higashi, K, Hamada, H, Kohno, Y. Prognostic impact of vascular leakage in acute Kawasaki disease. Circulation 2003; 108: 325–330.CrossRefGoogle ScholarPubMed
6. Newburger, JW, Takahashi, M, Gerber, MA, et al. 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.CrossRefGoogle Scholar
7. Briars, GL, Bailey, BJ. Surface area estimation: pocket calculator v nomogram. Arch Dis Child 1994; 70: 246–247.CrossRefGoogle ScholarPubMed
8. Devereux, R, Reichek, N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation 1977; 55: 613–618.CrossRefGoogle ScholarPubMed
9. de Zorzi, A, Colan, SD, Gauvreau, K, Baker, AL, Sundel, RP, Newburger, JW. Coronary artery dimensions may be misclassified as normal in Kawasaki disease. J Pediatr 1998; 133: 254–258.CrossRefGoogle ScholarPubMed
10. Appleton, CP, Jensen, JL, Hatle, LK, Oh, JK. Doppler evaluation of left and right ventricular diastolic function: a technical guide for obtaining optimal flow velocity recordings. J Am Soc Echocardiogr 1997; 10: 271–291.CrossRefGoogle ScholarPubMed
11. Garcia, MJ, Thomas, JD, Klein, AL. New Doppler echocardiographic applications for the study of diastolic function. J Am Coll Cardiol 1998; 32: 865–875.CrossRefGoogle Scholar
12. Galderisi, M, Benjamin, EJ, Evans, JC, et al. Intra- and interobserver reproducibility of Doppler-assessed indexes of left ventricular diastolic function in a population-based study (the Framingham Heart Study). Am J Cardiol 1992; 70: 1341–1346.CrossRefGoogle Scholar
13. Garcia, MJ, Palac, RT, Malenka, DJ, Terrell, P, Plehn, JF. Color M-mode Doppler flow propagation velocity is a relatively preload-independent index of left ventricular filling. J Am Soc Echocardiogr 1999; 12: 129–137.CrossRefGoogle ScholarPubMed
14. Border, WL, Michelfelder, EC, Glascock, BJ, et al. Color-M-mode and Doppler tissue evaluation of diastolic function in children: Simultaneous correlation with invasive indices. J Am Soc Echocardiogr 2003; 16: 988–994.CrossRefGoogle ScholarPubMed