@Article{chd.12787,
AUTHOR = {Aura A. Sanchez, Sara K. Sexson Tejtel, Myriam E. Almeida‐Jones, Douglas K. Feagin, Carolyn A. Altman, Ricardo H. Pignatelli},
TITLE = {Comprehensive left ventricular myocardial deformation assessment in children with Kawasaki disease},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {6},
PAGES = {1024--1031},
URL = {http://www.techscience.com/schd/v14n6/38895},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> Children with Kawasaki disease (KD) with persistent coronary artery 
aneurysms (CAAs) can develop chronic vasculopathy and subsequent myocardial 
ischemia. Early detection of this process is challenging. Myocardial deformation anal‐
ysis can detect early alterations in myocardial performance. We aim to determine 
whether there are differences in myocardial deformation between KD patients with 
and without CAAs.<br/>
<b>Design:</b> This is a cross‐sectional study of 123 echocardiograms performed on 103 
children with KD. Myocardial deformation was measured with two‐dimensional 
speckle tracking (2DSTE). The echocardiograms were divided into groups according 
to the KD phase in which they were performed: acute, subacute, and convalescent/
chronic. The convalescent/chronic phase group was then divided based on the pres‐
ence or absence of CAAs. Left ventricular (LV) global longitudinal strain (GLS), global 
longitudinal strain rate (GLSSR), global circumferential strain (GCS), global circum‐
ferential systolic strain rate (GCSSR), peak torsion, and torsion rate were measured.<br/>
<b>Results:</b> The numbers of echocardiograms analyzed in each of the KD phase groups 
were: 31 acute, 25 subacute, and 67 convalescent/chronic. Myocardial deformation 
was within normal limits in all groups. However, GLSSR, GCSSR, peak torsion, and 
torsion rate were lower in the convalescent/chronic phase group than in the acute 
phase group (mean, −1.37 ± 0.24 vs −1.55 ± 0.21 1/s; −1.63 ± 0.27 vs −1.84 ± 0.35 1/s; 
2.49 ± 1.13 vs 3.41 ± 2.60 °/cm, and 21.97 ± 8.36 vs 26.69 ± 10.86 °/cm/s; P < .05 
for all). The convalescent/chronic phase subgroup with CAAs had lower GLSSR and 
GCSSR than the subgroup without CAAs (mean, −1.23 ± 0.22 vs −1.42 ± 0.22 1/s; 
−1.46 ± 0.25 vs −1.68 ± 0.26 1/s, P < .05 for both).<br/>
<b>Conclusions:</b> Children in the convalescent/chronic phase of KD have a subtle de‐
crease in strain rate when compared to the acute phase, although within the normal 
range. This decrease is more pronounced in children with CAAs than those without 
CAAs. Longitudinal studies are needed to discern whether low‐normal strain rate 
predicts decreased myocardial function in the long term.},
DOI = {10.1111/chd.12787}
}