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Echocardiographic Evaluation of Left Ventricular Function in Kawasaki Disease : Effect of Immune Globulin

Korean Journal of Pediatrics 2004;47(6):665-671.
Published online June 15, 2004.
Echocardiographic Evaluation of Left Ventricular Function in Kawasaki Disease : Effect of Immune Globulin
Mi-Jin Jung
Department of Pediatrics, College of Medicine, Dankook University, Cheonan, Korea
가와사끼 질환에서 심에코로 측정한 좌심실의 수축 및 이완 기능의 평가 : 면역 글로불린 치료 전후의 비교
단국대학교 의과대학 소아과학교실
Mi-Jin Jung, Email: mi_jinjung@dankook.ac.kr
: The purpose of this investigation was to identify the impaired myocardial function and improvement with immune globulin in Kawasaki disease.
: The myocardial performance and diastolic function were evaluated in 52 patients. M-mode and Doppler echocardiography were performed before(pre) and after immune globulin treatment : two to nine days(pre), five to 15 days(period one), 14 to 35 days(period two), 49 to 77 days(period three) from onset, respectively.
: Myocardial performance of the patients compared to normal controls by fractional shortening(mean 33.6% vs 35.6% : P=0.07) and Tei index(mean 0.49 vs 0.47, P=0.1) was reduced at present, and improved after immune globulin(34.7%, 0.47 respectively), but was statistically not significant. Doppler echocardiography showed decreased isovolumic relaxation time(mean 38 ms vs 49 ms, P< 0.001), deceleration time(mean 72 ms vs 87 ms, P<0.001) and pulmonary vein S and D velocity time integral ratio(1.46 vs 1.66, P=0.1). Only IVRT showed significant differences after immune globulin (38-49-49-49 ms, P<0.001).
: I conclude that patients with Kawasaki disease exhibit decreased myocardial performance at present and improvement after immune globulin treatment, but it is not as peculiar as the published reports. The diastolic function assessed by Doppler echocardiography shows similar features to the restrictive pattern of diastolic dysfunction, but needs to be compared with febrile controls to determine.
Key Words: Kawasaki disease, Myocardial function, Echocardiography, Immune globulin

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