Abnormal myocardial work in children with Kawasaki disease

Abstract Kawasaki disease (KD) can be associated with high morbidity and mortality due to coronary artery aneurysms formation and myocardial dysfunction. Aim of this study was to evaluate the diagnostic performance of non-invasive myocardial work in predicting subtle myocardial abnormalities in Kawa...

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Autores principales:	Jolanda Sabatino, Nunzia Borrelli, Alain Fraisse, Jethro Herberg, Elena Karagadova, Martina Avesani, Valentina Bucciarelli, Manjit Josen, Josefa Paredes, Enrico Piccinelli, Maraisa Spada, Sylvia Krupickova, Ciro Indolfi, Giovanni Di Salvo
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e03b734710f74039bbdc4a8329f92fb8
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spelling	oai:doaj.org-article:e03b734710f74039bbdc4a8329f92fb82021-12-02T14:26:20ZAbnormal myocardial work in children with Kawasaki disease10.1038/s41598-021-86933-52045-2322https://doaj.org/article/e03b734710f74039bbdc4a8329f92fb82021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86933-5https://doaj.org/toc/2045-2322Abstract Kawasaki disease (KD) can be associated with high morbidity and mortality due to coronary artery aneurysms formation and myocardial dysfunction. Aim of this study was to evaluate the diagnostic performance of non-invasive myocardial work in predicting subtle myocardial abnormalities in Kawasaki disease (KD) children with coronary dilatation (CADL). A total of 100 patients (age 8.7 ± 5 years) were included: 45 children with KD and CADL (KD/CADL) (Z-score > 2.5), 45 age-matched controls (CTRL) and, finally, an additional group of 10 children with KD in absence of coronary dilatation (KD group). Left ventricular (LV) systolic function and global longitudinal strain (GLS) were assessed. Global myocardial work index (MWI) was calculated as the area of the LV pressure-strain loops. From MWI, global Constructive Work (MCW), Wasted Work (MWW) and Work Efficiency (MWE) were estimated. Despite normal LV systolic function by routine echocardiography, KD/CADL patients had lower MWI (1433.2 ± 375.8 mmHg% vs 1752.2 ± 265.7 mmHg%, p < 0.001), MCW (1885.5 ± 384.2 mmHg% vs 2175.9 ± 292.4 mmHg%, p = 0.001) and MWE (994.0 ± 4.8% vs 95.9 ± 2.0%, p = 0.030) compared to CTRL. Furthermore, MWI was significantly reduced in children belonging to the KD group in comparison with controls (KD: 1498.3 ± 361.7 mmHg%; KD vs CTRL p = 0.028) and was comparable between KD/CADL and KD groups (KD/CADL vs KD p = 0.896). Moreover, KD/CADL patients with normal GLS (n = 38) preserved significant differences in MWI and MCW in comparison with CTRL. MWI, MCW and MWE were significantly reduced in KD children despite normal LVEF and normal GLS. These abnormalities seems independent from CADL. Thus, in KD with normal LVEF and normal GLS, estimation of MWI may be a more sensitive indicator of myocardial dysfunction.Jolanda SabatinoNunzia BorrelliAlain FraisseJethro HerbergElena KaragadovaMartina AvesaniValentina BucciarelliManjit JosenJosefa ParedesEnrico PiccinelliMaraisa SpadaSylvia KrupickovaCiro IndolfiGiovanni Di SalvoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jolanda Sabatino Nunzia Borrelli Alain Fraisse Jethro Herberg Elena Karagadova Martina Avesani Valentina Bucciarelli Manjit Josen Josefa Paredes Enrico Piccinelli Maraisa Spada Sylvia Krupickova Ciro Indolfi Giovanni Di Salvo Abnormal myocardial work in children with Kawasaki disease
description	Abstract Kawasaki disease (KD) can be associated with high morbidity and mortality due to coronary artery aneurysms formation and myocardial dysfunction. Aim of this study was to evaluate the diagnostic performance of non-invasive myocardial work in predicting subtle myocardial abnormalities in Kawasaki disease (KD) children with coronary dilatation (CADL). A total of 100 patients (age 8.7 ± 5 years) were included: 45 children with KD and CADL (KD/CADL) (Z-score > 2.5), 45 age-matched controls (CTRL) and, finally, an additional group of 10 children with KD in absence of coronary dilatation (KD group). Left ventricular (LV) systolic function and global longitudinal strain (GLS) were assessed. Global myocardial work index (MWI) was calculated as the area of the LV pressure-strain loops. From MWI, global Constructive Work (MCW), Wasted Work (MWW) and Work Efficiency (MWE) were estimated. Despite normal LV systolic function by routine echocardiography, KD/CADL patients had lower MWI (1433.2 ± 375.8 mmHg% vs 1752.2 ± 265.7 mmHg%, p < 0.001), MCW (1885.5 ± 384.2 mmHg% vs 2175.9 ± 292.4 mmHg%, p = 0.001) and MWE (994.0 ± 4.8% vs 95.9 ± 2.0%, p = 0.030) compared to CTRL. Furthermore, MWI was significantly reduced in children belonging to the KD group in comparison with controls (KD: 1498.3 ± 361.7 mmHg%; KD vs CTRL p = 0.028) and was comparable between KD/CADL and KD groups (KD/CADL vs KD p = 0.896). Moreover, KD/CADL patients with normal GLS (n = 38) preserved significant differences in MWI and MCW in comparison with CTRL. MWI, MCW and MWE were significantly reduced in KD children despite normal LVEF and normal GLS. These abnormalities seems independent from CADL. Thus, in KD with normal LVEF and normal GLS, estimation of MWI may be a more sensitive indicator of myocardial dysfunction.
format	article
author	Jolanda Sabatino Nunzia Borrelli Alain Fraisse Jethro Herberg Elena Karagadova Martina Avesani Valentina Bucciarelli Manjit Josen Josefa Paredes Enrico Piccinelli Maraisa Spada Sylvia Krupickova Ciro Indolfi Giovanni Di Salvo
author_facet	Jolanda Sabatino Nunzia Borrelli Alain Fraisse Jethro Herberg Elena Karagadova Martina Avesani Valentina Bucciarelli Manjit Josen Josefa Paredes Enrico Piccinelli Maraisa Spada Sylvia Krupickova Ciro Indolfi Giovanni Di Salvo
author_sort	Jolanda Sabatino
title	Abnormal myocardial work in children with Kawasaki disease
title_short	Abnormal myocardial work in children with Kawasaki disease
title_full	Abnormal myocardial work in children with Kawasaki disease
title_fullStr	Abnormal myocardial work in children with Kawasaki disease
title_full_unstemmed	Abnormal myocardial work in children with Kawasaki disease
title_sort	abnormal myocardial work in children with kawasaki disease
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/e03b734710f74039bbdc4a8329f92fb8
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Abnormal myocardial work in children with Kawasaki disease

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