The Relationship Between Cardiac Events and Diastolic Function in Adolescents With Severe Coronary Involvements After Kawasaki Disease

  • Hiroshi Kanamaru, Department of Pediatrics and Child Health, Nihon University School of Medicine, Japan
  • Kensuke Karasawa, Department of Pediatrics and Child Health, Nihon University School of Medicine, Japan
  • Takahiro Nakamura, Department of Pediatrics and Child Health, Nihon University School of Medicine, Japan
  • Junji Fukuhara, Department of Pediatrics and Child Health, Nihon University School of Medicine, Japan
  • Mamoru Ayusawa, Department of Pediatrics and Child Health, Nihon University School of Medicine, Japan
  • Naokata Sumitomo, Department of Pediatrics and Child Health, Nihon University School of Medicine, Japan
  • Tomoo Okada, Department of Pediatrics and Child Health, Nihon University School of Medicine, Japan
  • Hideo Mugishima, Department of Pediatrics and Child Health, Nihon University School of Medicine, Japan

    • (Background) The purpose of this study was to clarify relations between cardiac events and diastolic function evaluated by quantitative gated SPECT (QGS) in adolescents with severe coronary involvements after Kawasaki disease (KD).
    (Methods) Sixteen patients with mean age 20.6 year-old who had severe coronary involvements after KD were performed QGS using Thallium-201 at rest and Tecnetium-99m tetrofosmin at erogometer stress. Ejection fraction (EF), peak ejection rate (PER), peak filling rate (PFR) and time to peak filling (TTPF) was evaluated by QGS (Philips Auto QUANT Ver.6.0) at rest, at stress and as the ratio of stress/rest. Severity score (SS) and extent score (ES) were evaluated by the myocardial perfusion image. We compared parameters between patients with cardiac events defined as the status resulted in coronary obstruction based on the findings of coronary angiogram and without events.
    (Results) There was no significant difference in SS, ES, EF, PER. PFR at stress resulted 2.58±0.44 EDV/s and 3.19±0.36 EDV/s (p<0.05), but no significant difference in PFR at rest, in TTPF at rest and stress. The ratio of stress/rest resulted 1.03±0.19 and 1.28±0.29 in PFR (p<0.05), 1.19±0.24 and 0.92±0.08 in TTPF (p<0.01).
    (Conclusion) Cardiac events that relate to coronary obstruction may cause diastolic dysfunction rather than decreased perfusion in adolescents with severe coronary involvements after KD.