Abstract 18847: Impact of Coronary Artery Aneurysms in Myocardial Deformation of Convalescent Kawasaki Disease Patients

Abstract

Background: Abnormal strain, independent of coronary involvement, has been reported in the acute phase of KD. However, there is limited data about the impact of coronary aneurysms in myocardial deformation during the convalescent phase of KD. Objective: To perform a comprehensive assessment of myocardial deformation in patients with KD during the convalescent phase and assess for the effect of coronary artery aneurysms. Methods: KD patients with echocardiograms performed during the convalescent phase (>42 days from fever onset to study date) between 8/2013 -11/2014, and with adequate images for analysis with two-dimensional speckle tracking echocardiography (2DSTE) were included. Demographic, clinical, 2D and 2DSTE parameters were measured, including left ventricular global longitudinal strain (GLS), global circumferential strain (GCS) and strain rate (SR), torsion and right ventricular longitudinal strain (RLS) and SR. The patients with and without aneurysms were compared using Chi-square and T-test. Linear regression was used to assess association between variables. Results: A total of 67 patients were included. Table 1 shows the demographic, clinical and echocardiographic data. The groups differ in heart rate (HR) and body surface area (BSA). Treatment resistance and coronary involvement at presentation were more frequent in the aneurysms group. The myocardial deformation values were within normal limits for age. However, the aneurysms group had significantly lower GLSR and GCSR relative to the group without aneurysms. GLSR was associated with BSA and HR and GCSR with age, p<0.05 for all. Conclusions: Convalescent KD patients with aneurysms have subtle decrease in LV longitudinal and circumferential myocardial deformation. This data suggests potential impact of chronic coronary involvement in the myocardial function of KD patients that warrants follow-up. BSA, HR and age should be considered when evaluating GLSR and GCSR.