Diastolic Function in Children with Kawasaki Disease

Background: Coronary artery dilation (CAD) and left ventricular systolic dysfunction are recognized complications of Kawasaki Disease (KD). Diastolic function assessed by echocardiography in the KD patient population and its interrelationship to the KD course, systolic dysfunction, and CAD is less well characterized. The purpose of this study was to determine whether diastolic function is impaired in KD patients and whether there are any clinical correlates.

Design/methods: All KD patients with an echocardiogram recording of tissue Doppler velocities were included. Patients were analyzed based on CAD (Group I: patients who had CAD during their disease course; Group II: patients who never had CAD). In addition, we compared measures of diastolic function in patients with echocardiograms 0-30 days (n=35) and >30 days (n=72) post-IVIG treatment.

Results: 116 patients (80 males) were included (mean age, 7.7±6.7 years; mean time since KD onset, 4.0±5.6 years). Group I (41 patients, 36%), compared to Group II, had decreased E'(lateral) and longer mitral early deceleration time. E'(lateral) and E'(septal) were significantly decreased in patients 0-30 days vs. >30 days post-IVIG, whereas mitral early deceleration time was not significantly different.

Conclusion: Our results demonstrate that there is impaired relaxation in KD patients in the early phase of the disease and in KD patients with CAD during the disease course.