Sequential Changes in Left Ventricular Systolic Myocardial Deformation Mechanics in Children with Recurrent Kawasaki Disease

BACKGROUND: Sequential changes in left ventricular (LV) systolic function over time in patients with recurrent episodes of Kawasaki disease (KD) remain unclear. METHODS: Twenty-five children with recurrent KD were retrospectively studied. Using conventional echocardiographic parameters and myocardial deformation analysis, systolic LV function in children in initial and recurrent KD episodes were compared with separate control groups, comprising 15 controls each. Recurrent KD was defined as occurring at an interval of ≥2 months between the initial and recurrent episodes. RESULTS: The interval range between initial and recurrent episodes of KD was 3–103 months. In children with KD, 8 (32%) were <1 year of age at the initial episode, 10 (40%) had a recurrence within 1 year of the initial episode, and 4 (16%) and 5 (20%) were intravenous immune globulin nonresponders in initial and recurrent episodes, respectively. In both the initial and recurrent episodes of KD, the mean LV longitudinal peak systolic ε was all within normal range. However, when compared to controls, mean LV longitudinal peak systolic ε was decreased in patients with KD in the acute phases of both the initial and recurrent episodes. When compared to controls, mean LV longitudinal peak systolic ε was decreased in patients with KD in the convalescent phase of the recurrent episodes. CONCLUSIONS: Subclinical decreases in myocardial systolic deformation, as evidenced by decreased LV longitudinal peak systolic ε, may persist in children in the convalescent phase of recurrent KD; further studies involving larger numbers of patients may be needed for verification.