Echocardiographic findings in pediatric multisystem inflammatory syndrome associated with COVID-19 in the United States
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...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020
|
| Online Access: | http://psasir.upm.edu.my/id/eprint/88547/ http://psasir.upm.edu.my/id/eprint/88547/1/ABSTRACT.pdf |
| _version_ | 1848860642713272320 |
|---|---|
| author | Matsubara, Daisuke Kauffman, Hunter L. Wang, Yan Calderon-Anyosa, Renzo Nadaraj, Sumekala Elias, Matthew D. White, Travus J. Torowicz, Deborah L. Yubbu, Putri Giglia, Therese M. Hogarty, Alexa N. Rossano, Joseph W. Quartermain, Michael D. Banerjee, Anirban |
| author_facet | Matsubara, Daisuke Kauffman, Hunter L. Wang, Yan Calderon-Anyosa, Renzo Nadaraj, Sumekala Elias, Matthew D. White, Travus J. Torowicz, Deborah L. Yubbu, Putri Giglia, Therese M. Hogarty, Alexa N. Rossano, Joseph W. Quartermain, Michael D. Banerjee, Anirban |
| author_sort | Matsubara, Daisuke |
| building | UPM Institutional Repository |
| collection | Online Access |
| description | 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.METHODSA 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 score¼3.15) 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. (J Am Coll Cardiol 2020;76:1947–61) © 2020 by the American College of Cardiology Foundation. |
| first_indexed | 2025-11-15T12:48:29Z |
| format | Article |
| id | upm-88547 |
| institution | Universiti Putra Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T12:48:29Z |
| publishDate | 2020 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | upm-885472021-12-23T08:03:59Z http://psasir.upm.edu.my/id/eprint/88547/ Echocardiographic findings in pediatric multisystem inflammatory syndrome associated with COVID-19 in the United States Matsubara, Daisuke Kauffman, Hunter L. Wang, Yan Calderon-Anyosa, Renzo Nadaraj, Sumekala Elias, Matthew D. White, Travus J. Torowicz, Deborah L. Yubbu, Putri Giglia, Therese M. Hogarty, Alexa N. Rossano, Joseph W. Quartermain, Michael D. Banerjee, Anirban 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.METHODSA 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 score¼3.15) 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. (J Am Coll Cardiol 2020;76:1947–61) © 2020 by the American College of Cardiology Foundation. Elsevier 2020 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/88547/1/ABSTRACT.pdf Matsubara, Daisuke and Kauffman, Hunter L. and Wang, Yan and Calderon-Anyosa, Renzo and Nadaraj, Sumekala and Elias, Matthew D. and White, Travus J. and Torowicz, Deborah L. and Yubbu, Putri and Giglia, Therese M. and Hogarty, Alexa N. and Rossano, Joseph W. and Quartermain, Michael D. and Banerjee, Anirban (2020) Echocardiographic findings in pediatric multisystem inflammatory syndrome associated with COVID-19 in the United States. Journal of the American College of Cardiology, 76 (17). 1947 - 1961. ISSN 1876-7605 https://www.sciencedirect.com/science/article/pii/S0735109720364883 10.1016/j.jacc.2020.08.056 |
| spellingShingle | Matsubara, Daisuke Kauffman, Hunter L. Wang, Yan Calderon-Anyosa, Renzo Nadaraj, Sumekala Elias, Matthew D. White, Travus J. Torowicz, Deborah L. Yubbu, Putri Giglia, Therese M. Hogarty, Alexa N. Rossano, Joseph W. Quartermain, Michael D. Banerjee, Anirban Echocardiographic findings in pediatric multisystem inflammatory syndrome associated with COVID-19 in the United States |
| title | Echocardiographic findings in pediatric multisystem inflammatory syndrome associated with COVID-19 in the United States |
| title_full | Echocardiographic findings in pediatric multisystem inflammatory syndrome associated with COVID-19 in the United States |
| title_fullStr | Echocardiographic findings in pediatric multisystem inflammatory syndrome associated with COVID-19 in the United States |
| title_full_unstemmed | Echocardiographic findings in pediatric multisystem inflammatory syndrome associated with COVID-19 in the United States |
| title_short | Echocardiographic findings in pediatric multisystem inflammatory syndrome associated with COVID-19 in the United States |
| title_sort | echocardiographic findings in pediatric multisystem inflammatory syndrome associated with covid-19 in the united states |
| url | http://psasir.upm.edu.my/id/eprint/88547/ http://psasir.upm.edu.my/id/eprint/88547/ http://psasir.upm.edu.my/id/eprint/88547/ http://psasir.upm.edu.my/id/eprint/88547/1/ABSTRACT.pdf |