| Objectives:1 To investigate and assess ventricular myocardial deformation during different phases of Kawasaki disease(KD)by two-dimensional speckle tracking echocardiography(STE).2 To make a quantitative analysis on myocardial fibrosis by cardiac integrated backscatter(CIB)in Han race Kawasaki disease children.Methods:1 From 2014 to 2016 year,a total of ninety-one patients with KD(sixty-one males,thirty females,age of 3.2±1.9 years)were recruited randomly as the research group,which was divided into acute phase group,convalescent phase group and chronic phase group.Based on whether occuring coronary artery lesions,the acute phase group was then subdivided.Meanwhile 56 healthy subjects(thirty-six males,twenty females,age of 3.2±1.7 years)were recruited randomly as control group.Subsequently,two-dimensional echocardiography was applied for collecting all myocardial motion images.Left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS)and other indexes were analyzed by traditional echocardiography and tissue Doppler imaging(TDI).Last but not least,global longitudinal strain(GLS),global longitudinal strain rate(GLSR)and global circumferential strain(GCS),global strain rate(GCSR)were calculated via QLAB version 9.0 software.2 During 2013 to 2015 year,ninety Kawasaki disease children(fifty-eight males,thirty-two females,age of 18.40±10.07 months)and ninety healthy subjects(fifty-five males,thirty-five females,age of 17.93±11.59 months)were recruited randomly.According to KD status,KD children were categorized into three groups: acute phase group,subacute phase group and convalescence phase group.Based on coronary artery status,KD patients were then subdivided into three groups: group without coronary artery lesions,group with coronary artery dilations and group with coronary artery aneurysms.Age and gender were matched.Subsequently,echocardiographic parameters and parasternal mid-level short-axis view of all subjects were measured and collected by conventional two-dimensional echocardiography.The calibrated integrated backscatter was assessed by using QLAB version 9.0 software.Results:1 No statistic difference was found in parameters by conventional echocardiography,i.e.LVEF and LVFS among three groups.2 GLS of acute group and chronic group were significantly reduced,Compared with control group,(P<0.01).3 GCS and GCSR of each KD group of three phases were significantly lower than that in control group(P<0.01).4 Differences of GCSR among three KD groups in different phases were significant(P<0.01).5 GLS,GLSR,GCS and GCSR were reduced more significantly in coronary artery lesions subgroup than that of coronary artery without injury subgroup.6 The myocardial calibrated integrated backscatter values of left ventricles in acute,subacute and convalescence phase groups of KD were significantly greater than those of control group(P<0.001).7 The left ventricular myocardial calibrated integrated backscatter values of KD children with coronary atery dilations and coronary artery aneurysms in different phases were significantly higher than those of KD children without coronary artery lesions.8 Myocardial calibrated integrated backscatter values of KD chidren without coronary artery lesions were significantly higher(P<0.001),compared with healthy control group.9 From Pearson association analysis,The left ventricular myocardial calibrated integrated backscatter values were positively correlated with coronary artery status in acute(r=0.331,P<0.001),subacute(r=0.456,P<0.001)and convalescence(r=0.407,P<0.001)phase groups of KD.Conclusions:1 Myocardial damage happened in varying degrees at different phases of KD.2 Coronary artery lesions in acute phase of KD may do harm to myocardial function.3 Suggesting that myocardial fibrosis may occur during early episodes of KD.4 Possibly existing regarding correlations of calibrated integrated backscatter and myocardial fibrosis.5 There is a positive association between calibrated integrated backscatter value and the status of the coronary artery in KD.Part Ⅰ Evaluation of myocardial deformation in children with Kawasaki disease by two dimensional speckle tracking echocardiographyObjective: To investigate and assess the diagnostic value of left ventricular myocardial deformation during different phases of Kawasaki disease(KD)by two-dimensional speckle tracking echocardiography.Methods:1 From 2014 to 2016 year,a total of ninety-one patients with KD(sixty-one males,thirty females,age of 3.2 ± 1.9 years)were recruited randomly as the research group,which was divided into acute phase group A(n=19),convalescent phase group B(n=23)and chronic phase group C(n=49).Based on whether occuring coronary artery lesions,the acute phase group was then subdivided.Meanwhile 56 healthy subjects(thirty-six males,twenty females,age of 3.2 ± 1.7 years)were recruited randomly as control group.2 Two-dimensional echocardiography was applied for collecting all myocardial motion images.Left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS)and other indexes were analyzed by traditional echocardiography and tissue Doppler imaging(TDI).3 Global longitudinal strain(GLS),global longitudinal strain rate(GLSR)and global circumferential strain(GCS),global strain rate(GCSR)were calculated via QLAB version 9.0 software offline.Results:1 No statistic difference was found in parameters by conventional echocardiography,i.e.LVEF and LVFS among three groups.The results of DTI image showed that lateral wall myocardial early diastolic velocity of group B was higher than A and C(P<0.05)among the research groups.Septum myocardial systolic velocity of group A and C were significantly lower than the control group(P<0.05).2 Compared with the control group,the GLS of group A and group C were significantly reduced(P<0.01).The GCS and GCSR of each group were significantly lower than that in the control group(P<0.01).The GCSR of three groups decreased significantly,but the difference among three groups was significant(P<0.01).3 Indexes of GLS,GLSR,GCS and GCSR were significantly reduced in coronary artery lesions subgroup than that of coronary artery without injury subgroup.Conclusions:1 Myocardial damage happened in varying degrees at different phases of KD.2 Coronary artery lesions in acute phase of KD may do harm to myocardial function.3 Two-dimensional speckle tracking echocardiography is an effective way to evaluate the subclinical cardiac dysfunction of KD.Part Ⅱ Quantitative Analysis of Myocardial Fibrosis of Kawasaki Disease by Cardiac Integrated BackscatterObjective: Providing quantitative information about myocartdial fibrosis by cardiac integrated backscatter analysis in Han race Kawasaki disease children.Methods:1 From 2013 to 2015 year,ninety Kawasaki disease children(fifty-eight males,thirty-two females,age of 18.40 ± 10.07 months)and ninety healthy subjects(fifty-five males,thirty-five females,age of 17.93 ± 11.59 months)were recruited randomly.Age and gender were matched.2 According to KD status,the KD children were categorized into three groups: acute phase group,subacute phase group and convalescence phase group.3 Based on coronary artery status,the KD patients were then subdivided into three groups: group without coronary artery lesions,group with coronary artery dilations and group with coronary artery aneurysms.Age and gender were matched.4 Clinical echocardiographic parameters and parasternal mid-level short-axis view of all subjects were measured and collected by clinical two-dimensional echocardiography.5 The calibrated integrated backscatter was assessed by using QLAB version 9.0 software to analyze the status of myocardial fibrosis in KDResults:1 Left ventricular systolic indexes of two-dimentional echocardiography measurement were normal in KD and control group.2 The myocardial calibrated integrated backscatter values of left ventricles in acute,subacute and convalescence phase groups of KD were significantly greater than those of control group(P<0.001).3 The left ventricular myocardial calibrated integrated backscatter values of KD children with coronary atery dilations and coronary artery aneurysms in different phases were significantly higher than those of KD children without coronary artery lesions.4 Myocardial calibrated integrated backscatter values of KD chidren without coronary artery lesions were significantly higher(P<0.001),compared with healthy control group.5 From Pearson association analysis,The left ventricular myocardial calibrated integrated backscatter values were positively correlated with coronary artery status in acute(r=0.331,P<0.001),subacute(r=0.456,P<0.001)and convalescence(r=0.407,P<0.001)phase groups of KD.Conclusions:1 Suggesting that myocardial fibrosis occurs possibly during early episodes of KD.2 Possibly existing regarding correlations of calibrated integrated backscatter and myocardial fibrosis.3 There is a positive association between calibrated integrated backscatter value and the status of the coronary artery in KD... |
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