| Full text | |
| Author(s): Show less - |
Leal, Gabriela Nunes
;
Astley, Camila
;
Lima, Marcos Santos
;
Rodrigues Diniz, Maria de Fatima
;
Lianza, Alessandro Cavalcanti
;
Shiraishi Sawamura, Karen Saori
;
Brito Menezes, Carolina Rocha
;
Martins Rodrigues da Silva, Camila Lino
;
Bain, Vera
;
Imada, Rodrigo
;
Chalela, William
;
Badue Pereira, Maria Fernanda
;
de Sousa Marques, Heloisa Helena
;
Buchpiguel, Carlos Alberto
;
Gualano, Bruno
;
Silva, Clovis Artur
Total Authors: 16
|
| Document type: | Journal article |
| Source: | ICROCIRCULATIO; v. 29, n. 3, p. 11-pg., 2022-02-20. |
| Abstract | |
Background Multisystem inflammatory syndrome in children (MIS-c) is associated with severe cardiovascular impairment and eventually death. Pathophysiological mechanisms involved in myocardial injury were scarcely investigated, and cardiovascular outcomes are uncertain. Autopsy studies suggested that microvascular dysfunction may be relevant to LV impairment. Objective We aimed to evaluate segmental LV longitudinal strain by 2DST echocardiography and myocardial flow reserve (MFR) by 13 N-ammonia PET-CT, in six surviving MIS-c patients. Methods Each patient generated 34 LV segments for combined 2DST and MRF analysis. MFR was considered abnormal when <2, borderline when between 2 and 2.5 and normal when >2.5. Results From July 2020 to February 2021, six patients were admitted with MIS-c: three males, aged 9.3 (6.6-15.7) years. Time from admission to the follow-up visit was 6.05 (2-10.3) months. Although all patients were asymptomatic and LV EF was >= 55%, 43/102 (42.1%) LV segments showed MFR r = .36, p = .03 for basal segments; r = .41, p = .022 for mid segments; r = .42, p = .021 for apical segments. Median peak systolic longitudinal strain was different among MRF categories: 18% (12%-24%) for abnormal, 18.5% (11%-35%) for borderline, and 21% (12%-32%) for normal MFR (p = .006). Conclusion We provided preliminary evidence that surviving MIS-c patients may present subclinical impairment of myocardial microcirculation. Segmental cardiac strain assessment 2DST seems useful for MIS-c cardiovascular follow-up, given its good correlation with 13 N-ammonia PET-CT derived MFR. (AU) | |
| FAPESP's process: | 15/03756-4 - Assessment of relevance of blood levels of drugs in the monitoring rheumatic autoimmune diseases: safety, effectiveness and adherence to therapy |
| Grantee: | Eloisa Silva Dutra de Oliveira Bonfá |
| Support Opportunities: | Research Projects - Thematic Grants |