Kawasaki disease from children to adults – Role of multimodality imaging in long term follow-up
█ Original article
Kádár Krisztina, Csöre Judit, Liptai Csilla, Tóth Attila, Kovács Attila, Molnár Levente, Suhai Imre, Assabiny Alexandra, Kuthi Luca*, Édes István*, Kertész Attila Béla*, Merkely Béla, Hartyánszky István
Semmelweis Egyetem, Városmajori Szív- és Érgyógyászati Klinika, Budapest
*Debreceni Egyetem, Kardiológiai és Szívsebészeti Klinika, Debrecen
Kawasaki disease (KD) is an acute immune vasculitis, occurring mainly in infants and children, where inflammation can lead to formation of coronary artery aneurysms and occlusions. Long-term effects of KD mainly rely on data from the Far East, where the epidemiological features of the disease are different from the Caucasian population.
Our goal was to assess the cardiovascular complication after childhood KD. We created a registry that will help in the evaluation the incidence and long term outcome of KD.
Methods: We have collected data from KD patients who have been registered since 1990 at Semmelweis University Heart and Vascular Center. The patients were studied using cardiac MR, coronary CT and echocardiography. In the latter method, we used speckle-tracking deformation analysis in addition to the routine parameters. Through the retrospective study we compared the results of patients who have had KD to data obtained from members of a matched control group.
Results: The cardiac imaging results of a total of 54 patients (16±6 years average age) were compared to data obtained from a 19-person control group. The disease occurred among children at an average of 3 years of age. Follow-up 9±4,9 years. Each of our patients had cardiac MRI; the first examination used in this study was at an average of 11 years of age, and coronary lesions occurred in 24% of patients. Echocardiography measurements showed that end-diastolic volume and ejection fraction was in the normal range, similar to the control group (KD vs. control: EDV: 57±26 vs. 52 ± 23 ml, EF: 67±8 vs. 67±7ml) and neither the speckle-tracking echocardiography deformation parameters showed systolic dysfunction (GLS: –18±5 vs. –18±4%).
Conclusions: Using the advanced cardiovascular imaging methods, it is possible to recognize an increasing number of cases in children and adults, who were previously involved in KD. The purpose of our register is the retrospective characterization of this disease in the Hungarian population, and the prospective follow-up of enrolled patients, to detect long-term cardiovascular effects of the disease.