Abstract
Background: Kawasaki disease (KD) is the leading cause of paediatric acquired heart disease in developed countries due to cardiovascular sequelae from coronary artery (CA)involvement, especially if inadequately treated. Current international guidelines recommend all patients diagnosed with KD should undergo echocardiograms at baseline, 2-weeks and 6-weeks following diagnosis [1]. We aimed to assess the utility of the 2-week echocardiogram in guiding management of KD patients.
Methods: A retrospective review was performed of children diagnosed with KD who underwent echocardiographic surveillance at Princess Margaret Hospital/Perth Children’s Hospital, between January 2004 and December 2019. Data was collated from electronic cardiology databases.
Results: Out of 352 patients, 79 (22.4%) patients had a2-week echocardiogram at a median of 13 days (interquartile range 7) following their initial study. Patients referred for a2-week study were younger than the remaining cohort(median 26 months (IQR 40) vs 42 months (IQR 43)). Of patients with 2-week echocardiogram, 45 patients (57.0%)had a normal baseline study; 39 (49.4%) remained normal at 2-weeks and 6-week follow-up. Of the patients who had week 2 echocardiograms, there was no statistically significant differences in overall CA dimensions between baseline,2-week and 6-week echocardiograms, with the exception of the left anterior descending (LAD) artery dimension at baseline and 6-weeks (median 0.83 (IQR 3.05) vs -0.36 (IQR1.9), p-value=0.003).
Conclusions: The clinical utility of the 2-week echocardiogram appears to be low, with no significant CA changes identified between the 2-week study and studies at baseline or at 6-weeks. This finding was evident in both patients with or without CA abnormalities at baseline and has potential implications for resource provision.
Methods: A retrospective review was performed of children diagnosed with KD who underwent echocardiographic surveillance at Princess Margaret Hospital/Perth Children’s Hospital, between January 2004 and December 2019. Data was collated from electronic cardiology databases.
Results: Out of 352 patients, 79 (22.4%) patients had a2-week echocardiogram at a median of 13 days (interquartile range 7) following their initial study. Patients referred for a2-week study were younger than the remaining cohort(median 26 months (IQR 40) vs 42 months (IQR 43)). Of patients with 2-week echocardiogram, 45 patients (57.0%)had a normal baseline study; 39 (49.4%) remained normal at 2-weeks and 6-week follow-up. Of the patients who had week 2 echocardiograms, there was no statistically significant differences in overall CA dimensions between baseline,2-week and 6-week echocardiograms, with the exception of the left anterior descending (LAD) artery dimension at baseline and 6-weeks (median 0.83 (IQR 3.05) vs -0.36 (IQR1.9), p-value=0.003).
Conclusions: The clinical utility of the 2-week echocardiogram appears to be low, with no significant CA changes identified between the 2-week study and studies at baseline or at 6-weeks. This finding was evident in both patients with or without CA abnormalities at baseline and has potential implications for resource provision.
| Original language | English |
|---|---|
| Article number | 387 |
| Pages (from-to) | S270 |
| Number of pages | 1 |
| Journal | Heart, Lung and Circulation |
| Volume | 30 |
| Issue number | Supplement 3 |
| DOIs | |
| Publication status | Published - 1 Jan 2021 |
| Externally published | Yes |