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Is strain echocardiography a more sensitive indicator of myocardial involvement in patients with multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2?

Part of: Echocardiography

Published online by Cambridge University Press:  24 March 2022

Eviç Z. Başar Open the ORCID record for Eviç Z. Başar [Opens in a new window] ,
Emre Usta ,
Gökmen Akgün ,
Hüseyin S. Güngör ,
Hafize E. Sönmez  and
Kadir Babaoğlu Open the ORCID record for Kadir Babaoğlu [Opens in a new window]
Eviç Z. Başar*
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
Emre Usta
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
Gökmen Akgün
Affiliation:
Department of Pediatric Cardiology, Faculty of Health Science, Darıca Farabi Training and Research Hospital, Kocaeli, Turkey
Hüseyin S. Güngör
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
Hafize E. Sönmez
Affiliation:
Department of Pediatric Rheumatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
Kadir Babaoğlu
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
*
Author for correspondence: Asist. Prof. Dr E. Z. Başar, Department of Pediatric Cardiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey. Tel: +905074630082; Fax: +902623037003. E-mail: [email protected]
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Abstract

Objective:

The aim of the study was to evaluate the early myocardial dysfunction detected by strain echocardiography in children with multisystem inflammatory syndrome related to SARS-CoV-2 infection.

Methods:

This cross-sectional study was conducted with 47 patients diagnosed with MIS-C and 32 healthy age- and gender-matched children. All patients underwent two-dimensional, colour, pulsed, and tissue Doppler, and 2D speckle tracking echocardiography examination at admission, 2 weeks, and 2 months after discharge. The MIS-C patient group was compared with the control group. Echocardiographic changes in MIS-C patients during follow-up were evaluated.

Results:

Of 47 patients, 30 (63.8%) were male and 17 (36.2%) were female. The mean age at diagnosis was 9.1 ± 4.3 (1.25–17) years. At admission, 25 patients had abnormal findings on conventional echocardiography. Among them, eight patients had left ventricular systolic dysfunction. Ejection fraction and fractional shortening were significantly lower in the patient group at admission compared to controls (p = 0.013, p = 0.010, respectively). While the ejection fraction was <55% in eight patients, and global longitudinal strain was lower than −2SD in 29 patients at admission. Global longitudinal strain z-score <−2SD persisted in 13 patients at 2-month follow-up. Ejection fraction increased above 55% in 3.42 ± 0.53 days in 7 of 8 patients with left ventricular systolic dysfunction, ejection fraction was 51% at discharge in one patient, and left ventricular systolic dysfunction persisted at the 6-month of follow-up.

Conclusion:

These results confirmed that speckle tracking echocardiography is more likely to detect subclinical myocardial damage compared to conventional echocardiography. In addition, it is a valuable method for follow-up in this patient group.

Keywords

Multisystem Inflammatory Syndrome related to SARS-CoV-2MIS-Cmyocarditisspeckle tracking echocardiography
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 10 , October 2022 , pp. 1657 - 1667
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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