Quantitative evaluation of left ventricular systolic function in children with Kawasaki disease by left ventricular pressure-strain loop
Objective To evaluate left ventricular systolic function in children with Kawasaki disease (KD) with different degrees of lesion by non-invasive left ventricular pressure-strain loop (LVPSL).Method A total of 55 pediatric patients with KD admitted to the Seventh Medical Center of PLA General Hospital from September 2020 to December 2022 were included in the study.KD patients were divided into dilation group (n=21) and undilation group (n=34) based on the presence or absence of coronary artery dilation.Twenty-eight healthy children matching the age and gender of the KD group in the same period were selected as the control group.KD patients and healthy children underwent echocardiography.The left ventricle global longitudinal strain (GLS),global work index (GWI),global constructive work (GCW),global wasted work (GWW),and global work efficiency (GWE) were calculated.The left ventricular conventional echocardiography and myocardial work parameters among the three groups were compared,and the correlation between myocardial work parameters and GLS and N-terminal pro B-type natriuretic peptide (NT-proBNP) were analyzed.Statistical methods performed by x2 test,one-way ANOVA,LSD-t test and Pearson correlation analysis.Result There was no significant differences in conventional echocardiography parameters among the three groups (all P>0.05).The GLS,GWI and GCW in dilation group were lower than those in control group and undilation group [GLS: (-19.5±2.9) ％ vs (-21.6±2.1) ％,(-21.4±2.4) ％; GWI: (1259±225) mm Hg％vs (1490±239) mm Hg％,(1459±233) mm Hg％; GCW: (1493±236) mm Hg％ vs (1687±226) mm Hg％,(1644±290) mm Hg％,all P<0.05],the GWW in dilation group was higher than that in control group and the undilation group [(66±29) mm Hg％ vs (49±23) mm Hg％,(53±20) mm Hg％,all P<0.05].There were no statistically significant differences in GLS,GWI,GCW and GWW among the undilation group and the control group (all P>0.05),and there were no statistically significant differences in GWE among the three groups (all P>0.05).The results of Pearson correlation analysis showed that,the GLS was negatively correlated with GWI and GCW (r=-0.717,P<0.001; r=-0.791,P<0.001).The GWI and GCW were negatively correlated with NT-proBNP (r=-0.749,P<0.001; r=-0.702,P<0.001).Conclusion Non-invasive LVPSL can quantitatively evaluate the changes in left ventricular myocardial work of KD children with different degrees of lesion,and it can early and sensitively reflect left ventricular systolic function damage.
Pressure-strain loopKawasaki diseaseCoronary arteriesLeft ventricular systolic functionMyocardial work
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