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Evaluation of myocardial function using the Tei index in patients with Kawasaki disease

Published online by Cambridge University Press:  18 December 2009

Gholamhossein Ajami ,
Mohammad Borzouee ,
Hamid Amoozgar ,
Feridoon Ashnaee ,
Sara Kashef ,
Mir Sabina Nesar  and
Mir Soleh Nesar
Gholamhossein Ajami*
Affiliation:
Divisions of Pediatric Cardiology and Immunology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran
Mohammad Borzouee
Affiliation:
Divisions of Pediatric Cardiology and Immunology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran
Hamid Amoozgar
Affiliation:
Divisions of Pediatric Cardiology and Immunology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran
Feridoon Ashnaee
Affiliation:
Divisions of Pediatric Cardiology and Immunology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran
Sara Kashef
Affiliation:
Divisions of Pediatric Cardiology and Immunology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran
Mir Sabina Nesar
Affiliation:
Divisions of Pediatric Cardiology and Immunology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran
Mir Soleh Nesar
Affiliation:
Divisions of Pediatric Cardiology and Immunology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran
*
Correspondence to: G.H. Ajami, MD, Department of Pediatrics, Nemazee Hospital, Shiraz, Iran; 71937-11351. Cell phone: +98-9173155386; Tele/fax: 98-711-6474298; E-mail: ajamigh@sums.ac.ir
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Abstract

Myocarditis is a well-recognized component of Kawasaki disease, with left ventricular dysfunction occurring in more than half of the patients during the acute phase of the disease. The purpose of our study was to evaluate myocardial function in these patients using the myocardial performance index, also known as the Tei index. In a prospective study, 14 patients underwent echocardiographic evaluation, first at the time of diagnosis of the disease, in its acute phase before treatment with intravenous immunoglobulin and then 2 weeks later after treatment with immunoglobulin. We assessed the Tei-index, the ejection fraction, shortening fraction, and the presence of valvar regurgitation, pericardial effusion, or coronary arterial involvement. As a control, we also assessed 22 healthy children, matched for age and sex with the study population. Of the patients, half had an increased left ventricular Tei-index in the acute phase, as compared with the data obtained after treatment, the index changing from 0.43 ± 0.08 to 0.35 ± 0.06 (p equal to 0.003). An increased index for the right ventricle was found in 5 patients (36%), values being 0.30 ± 0.05 as opposed to 0.26 ± 0.04 (p equal to 0.009). Of the patients, 5 (35.7%) also had decreased ejection fractions and proportional shortening fractions during the acute phase, confirming left ventricular dysfunction. We concluded that the Tei-index, which measures combined systolic and diastolic function, is a simple, sensitive, and accurate tool for estimating global myocardial dysfunction in patients with Kawasaki disease.

Keywords

MyocarditisGlobal myocardial dysfunctionDopplerderived ventricular function
Type
Original Articles
Information
Cardiology in the Young , Volume 20 , Issue 1 , February 2010 , pp. 44 - 48
Copyright
Copyright © Cambridge University Press 2009

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