Clinical Outcomes and Prognosis

1348920 - The relationship between myocardial changes and coronary arteries in children with Kawasaki disease of different stage: cardiac magnetic resonance native T1 mapping study

Wednesday, January 25, 2023

Location: E-POSTER

Presenting Author(s)

sp

shengkun peng, PhD

doctor
west china second university hospital, China (People's Republic)

Primary Author(s)

sp

shengkun peng, PhD

doctor
west china second university hospital, China (People's Republic)

Co-Author(s)

LW

Lingyi Wen, MD

doctor
west china second university hospital, Sichuan, China (People's Republic)
ZZ

Zhongqin Zhou, MD

doctor
west china second university hospital, China (People's Republic)
YG

Yingkun Guo, MD, PhD

doctor
west china second university hospital, Sichuan, China (People's Republic)

Background: Pathological biopsy revealed extensive myocardial inflammation/fibrosis of the myocardium in children with Kawasaki disease, regardless of coronary artery injury, and persisted even years after onset. Cardiac magnetic resonance examination has the advantage of tissue characteristic imaging. In this paper, we intend to use CMR to measure T1 mapping to quantitatively evaluate the myocardial inflammation/fibrosis in children with Kawasaki disease in different stages, and to analyze the relationship between myocardial native T1 and coronary artery dilatation in Kawasaki disease.

Methods: The study of children with KD was divided into chronic KD (onset＞8 weeks, chronic,n=63) and acute KD (within 6-8 weeks of onset, acute,n=41), and/or coronary artery dilation (CA Dilation, Z-score＞2.0) vs. without coronary artery dilation (Z-score ≤2.0) and compared with age-matched controls. left ventricle (LV) myocardium native T1 value (global, basal, middle, and apex) and coronary artery territory (left anterior descending branch(LAD) left circumflex branch(LCX), and right coronary artery (RCA)) native T1 value were obtained using T1 mapping sequence on Cardiac Magnetic Resonance. Comparisons were made between controls and (i) the entire KD group, (ii) the KD group subdivided by stage of disease, and(iii) the KD group subdivided by CA dilation.

Results:

(1) The LV myocardium native T1 values were higher in KD groups than control group ( p < 0.01 ), and acute KD group was higher than chronic KD group ( p < 0.05 ). (2) No significant difference in LV myocardium native T1 values has been observed among acute or chronic KD with CA dilation and without CA dilation (all p</span>＞0.05). No differences in CA territory (LAD, LCX, and RCA) myocardium native T1 values were seen between corresponding CA dilation and without CA dilation (all p >0.05). The Spearman correlation analysis between the Z-score of LAD, LCX, or RCA and corresponding CA territory myocardium native T1 values showed not significance (LAD：r=0.061，p=0.540；LCX: r=0.011，p=0.915; RCA：r=-0.132，p=0.183). After adjusting for clinical characteristics, the multivariate analysis demonstrated that the stage of disease was independently associated with the global native T1 value (β=-0.295, p=0.003, model R2=0.128).

Conclusion: The LV myocardium native T1 values in KD groups were higher than normal control group, acute KD group was higher than chronic KD group. There was no significant correlation between CA dilatation and myocardium native T1 values. We recommended children with KD should be followed up by CMR.