# Left ventricular function assessment in Kawasaki disease by two-dimensional global longitudinal systolic strain with automated function imaging

## TL;DR

This study uses strain echocardiography to detect lingering heart function issues in children who had Kawasaki disease, even when traditional tests show normal results.

## Contribution

The study introduces the use of two-dimensional global longitudinal peak systolic strain to assess subendocardial dysfunction in Kawasaki disease survivors.

## Key findings

- Global longitudinal peak strain was significantly lower in boys with Kawasaki disease compared to girls.
- Significant differences in strain were observed in specific heart segments supplied by the Left Circumflex artery.
- Strain echocardiography detected subendocardial dysfunction not visible with standard M-mode echocardiography.

## Abstract

Kawasaki disease is an acute febrile vasculitis of childhood mainly affecting children under 4 years of age. In the acute stage of the disease, heart function decreases and gradually returns to normal after treatment. However, subendocardial involvement may persist, which cannot be assessed by M-mode echocardiography. Strain echocardiography is a recently developed technique to assess subendocardial involvement of myocardial deformation. We aimed to study the stratified strain of left ventricular function in a Kawasaki patient at least 6 months after the acute stage of the disease with special conditions for entering the study using two-dimensional speckle-tracking imaging. Between September 2020 and October 2022, 27 healthy children and 27 children with a history of Kawasaki disease more than 6 months ago were evaluated using two-dimensional global longitudinal peak systolic strain with automated function imaging technology.

The mean age of patients was 5.6 years. With M-mode echocardiography, ejection fraction of each group was in the normal range. Mean (± standard deviation) global longitudinal peak strain in four-chamber view of girls with Kawasaki disease was − 23.74 ± 2.77, and that in boys with Kawasaki disease was − 20.93 ± 2.06 (P value = 0.008). GLPS (global longitudinal peak strain) was compared as an overall average and as in a separate segment, which showed significant difference in two comparisons. In our study, a decrease in the function of some cardiac segments is reported. Global longitudinal peak strain in four-chamber view was significantly lower in boys. Comparing different segments, a difference in global left ventricular long-axis strain was found between the two groups. On the other hand, there was a major difference between the two groups in the basal inferolateral, basal anterolateral, and mid-inferolateral, which receives blood from Left Circumflex artery.

Using stain echocardiography to detect continued subendocardial involvement in asymptomatic children with a history of Kawasaki disease for a better understanding of the condition, effective management and follow-up is recommended.