Abstract
Background The Cyclic variation (CV) of ultrasound integrated backscatter (IBS) from myocardium is a method of tissue characterization. The aims of this study are to evaluate severity of myocardial abnormalities quantitatively using IBS and to assess rate of resolution of myocardial abnormalities after intravenous immune globulin (IVIG). Methods The 43 KD patients comprised 2 groups: Group 1 consisted of 30 patients with responded to initial IVIG. Group 2 consisted of 13 patients with IVIG resistant KD. The CV of myocardium was measured in LV posterior wall using a specialized IBS signal processor (Sonos 5500, Agilent Tec. Inc). Results Before IVIG in KD patients, the CV of myocardium was lower than age-matched control patients (Group 1: 4.8±2.6, Group 2: 6.8±2.8, vs. control 9.2±2.1dB, p<0.05). In Group 1, the CV of myocardium increased at 48hours after IVIG (8.8±4.8dB) and no difference was found between group 1 and control. However, in Group 2, the CV of myocardium at 48 hours after IVIG did not increase (7.0±2.2dB), and that value still lower than the value in control (p<0.05). In Group 2, the CV of myocardium at 14 days of illness is still lower than value in control (7.1±2.1dB, p<0.05). The CV of myocardium in 3 patients in Group 2 still persisted lower value compared with that in controls at 1 month after KD onset. Conclusion The changes of the CV in myocardium correlated with clinical effects to IVIG. The abnormality of myocardium as assessed by IBS is typical at presentation for KD and that recovery is accelerated by IVIG in acute phase. In patients with IVIG resistant KD, however, the abnormalities of myocardium persist in convalescent phase. The long-term follow up is needed for not only coronary artery lesions but also abnormalities of LV myocardium in KD patients.
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Himeno, W., Ishii, M., Urabe, D. et al. Quantitative Evaluation of Severity of Left Ventricular Myocardial Abnormalities in Kawasaki Disease: The Tissue Characterization Study. Pediatr Res 53, 184 (2003). https://doi.org/10.1203/00006450-200301000-00186
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DOI: https://doi.org/10.1203/00006450-200301000-00186