TWO-DIMENSIONAL ECHOCARDIOGRAPHIC ASSESSMENT OF MYOCARDIAL ISCHEMIA AND INFARCTION IN KAWASAKI DISEASE

Abstract

Two-dimensional echocardiography (2DE) was used to study left ventricular wall motion in 10 normal subjects and 55 patients with Kawasaki Disease. These 65 cases could be divided into four groups by the findings of ECG, 2DE, Thallium 201 myocardial imaging and coronary angiography : group A (10 normal subjects) had normal findings in ECG and 2DE. group B (6 patients) had infarction and regional wall motion abnormalities in those examinations. group C (19 patients) had coronary aneurysms. group D (30 patients) had no infarction and coronary aneurysmal changes.Echocardiographic studies were performed in short and long axes of ventricle, which was divided into nine segments for analysis. Wall motion in each segment was classified as normal, hyperkinetic, hypokinetic, akinetic or dyskinetic. Based on this analysis a wall motion index was derived as an overall assessment of left ventricular asynergy. In group B, the wall motion index was 10.3±3.1, which was significantly higher that in group A (p < 0.001). In group C, the wall motion index was 2. 2 ± 2.3, which was also significantly higher than that in group A (p < 0.01). Between in group D and group A, the wall motion index had no significance.Therefore, two-dimensional echocardiography may be a useful method for detecting the presence of regional asynergy associated with myocardial ischemia and infarction in Kawasaki Disease.