Echocardiographic Findings in Pediatric Multisystem Inflammatory Syndrome Associated With COVID-19 in the United States.
J Am Coll Cardiol
; 76(17): 1947-1961, 2020 10 27.
Article
en En
| MEDLINE
| ID: mdl-32890666
ABSTRACT
BACKGROUND:
Centers from Europe and United States have reported an exceedingly high number of children with a severe inflammatory syndrome in the setting of coronavirus disease 2019, which has been termed multisystem inflammatory syndrome in children (MIS-C).OBJECTIVES:
This study aimed to analyze echocardiographic manifestations in MIS-C.METHODS:
A total of 28 MIS-C, 20 healthy control subjects and 20 classic Kawasaki disease (KD) patients were retrospectively reviewed. The study reviewed echocardiographic parameters in the acute phase of the MIS-C and KD groups, and during the subacute period in the MIS-C group (interval 5.2 ± 3 days).RESULTS:
Only 1 case in the MIS-C group (4%) manifested coronary artery dilatation (z score = 3.15) in the acute phase, showing resolution during early follow-up. Left ventricular (LV) systolic and diastolic function measured by deformation parameters were worse in patients with MIS-C compared with KD. Moreover, MIS-C patients with myocardial injury were more affected than those without myocardial injury with respect to all functional parameters. The strongest parameters to predict myocardial injury in MIS-C were global longitudinal strain, global circumferential strain, peak left atrial strain, and peak longitudinal strain of right ventricular free wall (odds ratios 1.45 [95% confidence interval (CI) 1.08 to 1.95], 1.39 [95% CI 1.04 to 1.88], 0.84 [95% CI 0.73 to 0.96], and 1.59 [95% CI 1.09 to 2.34], respectively). The preserved LV ejection fraction (EF) group in MIS-C showed diastolic dysfunction. During the subacute period, LVEF returned to normal (median from 54% to 64%; p < 0.001) but diastolic dysfunction persisted.CONCLUSIONS:
Unlike classic KD, coronary arteries may be spared in early MIS-C; however, myocardial injury is common. Even preserved EF patients showed subtle changes in myocardial deformation, suggesting subclinical myocardial injury. During an abbreviated follow-up, there was good recovery of systolic function but persistence of diastolic dysfunction and no coronary aneurysms.Palabras clave
Texto completo:
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Banco de datos:
MEDLINE
Asunto principal:
Neumonía Viral
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Ecocardiografía
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Infecciones por Coronavirus
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Síndrome de Respuesta Inflamatoria Sistémica
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Corazón
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Child
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Female
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Humans
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Male
Idioma:
En
Revista:
J Am Coll Cardiol
Año:
2020
Tipo del documento:
Article