Abstract
BACKGROUND: The changes in right ventricular (RV) contractility of Kawasaki disease (KD) still remain unclear. HYPOTHESIS: We aimed to determine whether RV systolic dysfunction can be detected by cardiac magnetic resonance (CMR) feature tracking and to find its association with coronary artery lesions (aneurysm, thrombosis and stenosis). METHODS: Peak systolic myocardial longitudinal, radial and circumferential strain and the strain rate (RVSL, RVSR, RVSC, RVSRL, RVSRR and RVSRC) in the global RV and three levels (basal, middle and apical) were measured in 66 patients with convalescent KD. A total of 20 controls were included. Comparisons were made with controls and among KD subgroups divided with coronary artery lesions. RESULTS: RVSC (-10.575% vs. -10.760%), RVSL (-18.150% vs. -18.712%) and RVSRC (-0.815/s vs. -0.924/s) were slightly lower in KD group without significant difference. All the strain and strain rate presented lowest in the basal level. In subgroup comparison, lower RVSL and RVSRL were observed in the giant coronary artery aneurysm (CAA) group; RVSR (15.844% vs. 16.897%), RVSRR (1.245/s vs. 1.322/s) and RVSRC (-0.715/s vs. -0.895/s) were lower in thrombosed group; RVSRL (-1.27/s vs. -1.503/s) were lower in stenosis group. All the comparison in subgroups did not reach significant difference. From the analysis of receiver operating characteristic curve, RVSRL had a better ability to identify KD with giant CAA and stenosis. For the identification of thrombosis, RVSRC had a better ability. CONCLUSIONS: Lower strain and strain rates of RV were detected in convalescent KD. More pronounced in those with persisting coronary artery lesions.