CARDIAC FUNCTION IN PATIENTS WITH KAWASAKI
DISEASE: DIPYRIDAMOLE STRESS ECHOCARDIOGRAPHY EVALUATION
Yu XY 1, Chen R1, Wang H1, Piao YA1,
Jiang KX2 and Xu CX2
Depts. 1Pediatrics and 2Ultrasonics,
The Second Clinical Hospital, China Medical University, Shenyang, China
Objective: Dipyridamole stress Doppler
echocardiography was used for evaluation of cardiac function in patients
with Kawasaki disease.
Methods: The study group included 21
patients (15 males and 6 females) with a history of Kawasaki disease,
ranging in age from 5 months to 13 years and 6 months (mean±SD, 2.7±2.4
years). Coronary artery
lesions had been determined in the entire patients by
echocardiography. Patients had
undergone dipyridamole stress 99mTC-MIBI myocardial
single-photon emission computed tomography (SPECT). According to the findings by SPECT,
the patients were categorized into two groups: group A (n=14) consisted of
children with abnormal distribution and group N (n=7) consisted of those
with normal distribution. The
ejection fraction (EF), cardiac index (CI), pre ejection period / left
ventricular ejection time (PEP/LVET) and Emax and Amax in mitral valve were
measured respectively by pulsed-wave Doppler echocardiography at rest,
after dipyridamole stress and one hour late.
Results: At rest, no significant
difference was seen in all parameters in patients with normal or abnormal
distribution on 99mTC imaging. But in the patients showing abnormal distribution after
stress, CI decrease significantly from 3.2±0.4 to 2.6±0.33L/m2.min
(p<0.05); PEP/LVET increased significantly from 0.32±0.04 to 0.39±0.07(p<0.05). A delayed study after stress showed
the recovery of CI and PEP/LVCET to the level at rest in all patients.
Sensitivities of abnormal CI and PEP/LVET were 75% and 81% respectively,
and specificities were 77% and 80% respectively, compared with results from
99mTC imaging. EF
and A/E did not different significantly after stress.
Conclusion: Dipyridamole stress
Doppler echocardiography is a noninvasive, and it is easy to perform and
repeat. Hence it may be a
useful method for serially evaluating cardiac function in patients with
Kawasaki disease