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Pulmonary Artery Dilation and Right Ventricular Function in Acute Kawasaki Disease
- Source :
- Pediatric Cardiology. 37:482-490
- Publication Year :
- 2015
- Publisher :
- Springer Science and Business Media LLC, 2015.
-
Abstract
- Coronary artery inflammation and aneurysm formation are the most common complications of Kawasaki disease (KD). Valvulitis and myocarditis are also well described and may lead to valvar regurgitation and left ventricular dysfunction. However, functional changes in the right heart have rarely been reported. We noted several acute KD patients with dilated pulmonary arteries (PA) and thus sought to systematically characterize PA size and right-heart function in an unselected cohort of KD patients cared for at a single clinical center. Clinical, laboratory, and echocardiographic data from 143 acute KD subjects were analyzed. PA dilation was documented in 23 subjects (16.1 %); these subjects had higher median right ventricle myocardial performance index (RV MPI), higher ratio of early tricuspid inflow velocity to tricuspid annular early diastolic velocity (TV E/e'), and lower median TV e' velocity compared to the non-PA dilation group (0.50 vs 0.38 p < 0.01, 4.2 vs 3.6 p < 0.05, and 13.5 vs 15.2 cm/s p < 0.01, respectively). Almost all subjects with PA dilation had improved PA Z-score, RV MPI, and TV E/e' in the subacute phase (p < 0.01). There were no significant differences in indices of left ventricle function between PA dilation group and non-PA dilation group. In summary, PA dilation was documented in 16 % of acute KD subjects. These subjects were more likely to have echocardiographic indices consistent with isolated RV dysfunction that improved in the subacute phase. The long-term consequence of these findings will require longitudinal studies of this patient population.
- Subjects :
- Male
Pulmonary Circulation
medicine.medical_specialty
Myocarditis
Adolescent
Heart Ventricles
Mucocutaneous Lymph Node Syndrome
Pulmonary Artery
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
030225 pediatrics
Internal medicine
medicine.artery
medicine
Humans
Child
Retrospective Studies
business.industry
Infant
Retrospective cohort study
Vascular surgery
medicine.disease
Dilatation
Cardiac surgery
medicine.anatomical_structure
Echocardiography
Ventricle
Child, Preschool
Pediatrics, Perinatology and Child Health
Cohort
Pulmonary artery
Linear Models
Ventricular Function, Right
Cardiology
Female
Kawasaki disease
Cardiology and Cardiovascular Medicine
business
Blood Flow Velocity
Subjects
Details
- ISSN :
- 14321971 and 01720643
- Volume :
- 37
- Database :
- OpenAIRE
- Journal :
- Pediatric Cardiology
- Accession number :
- edsair.doi.dedup.....e670bf7b43e5cec50c0b3ac04c4c1115