Document Detail


Dobutamine stress echocardiography in the evaluation of young patients with Kawasaki disease.
MedLine Citation:
PMID:  12522652     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There has been no consistent approach to the follow-up of Kawasaki disease patients for remote coronary perfusion abnormalities. Dobutamine stress echocardiography (DSE) has become a standard method for evaluation of perfusion abnormalities in adults with coronary artery disease. In addition, DSE has been used with success in some pediatric patients. The purposes of this study were to evaluate safety and accuracy of DSE in the follow-up of patients with Kawasaki disease, to evaluate whether DSE adds any additional value to the resting echocardiogram, and to determine the association of DSE results with American Heart Association (AHA) risk level categories. DSE was performed 1 month to 13 years after acute Kawasaki disease in 47 patients (range, 3.8-22.6 years; 33 males and 16 females). Patients were stratified according to AHA risk level categories (I-V). Ischemia was defined as a new or worsening regional wall motion abnormality or >1 mm ST segment depression on the electrocardiogram during DSE. In 45/47 patients, DSE was completed successfully (i.e., achievement of target heart rate or development of ischemia). No patients in risk levels lower than V (i.e., patients without coronary artery stenoses) had positive DSE, whereas 2/4 (50%) in the risk level V category had positive DSE, both of whom had coronary occlusion >50% confirmed by angiography. Of the 2 AHA risk level V patients with negative DSE, 1 had extensive collateralization and the other had coronary obstruction <50%. DSE is a safe and feasible method for the evaluation of children with Kawasaki disease. DSE provides a confirmatory benefit and may be a useful screening alternative to cardiac catheterization during follow-up. Patients in AHA risk levels I-IV are unlikely to have dobutamine-induced coronary perfusion abnormalities. Patients in the risk level V category may or may not have positive DSE depending on the degree of both coronary obstruction and collateralization.
Authors:
M V Zilberman; G Goya; S A Witt; B Glascock; T R Kimball
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2003-01-15
Journal Detail:
Title:  Pediatric cardiology     Volume:  24     ISSN:  0172-0643     ISO Abbreviation:  Pediatr Cardiol     Publication Date:    2003 Jul-Aug
Date Detail:
Created Date:  2003-07-04     Completed Date:  2003-11-20     Revised Date:  2008-02-20    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  338-43     Citation Subset:  IM    
Affiliation:
Non-invasive Cardiac Imaging and Hemodynamic Research Laboratory, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, C-4, Cincinnati, OH 45229-3039, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Distribution
Child
Child, Preschool
Cohort Studies
Coronary Angiography
Coronary Stenosis / epidemiology,  radiography,  ultrasonography*
Dobutamine / diagnostic use*
Echocardiography / methods*
Exercise Test*
Female
Follow-Up Studies
Humans
Incidence
Male
Mucocutaneous Lymph Node Syndrome / epidemiology,  ultrasonography*
Prospective Studies
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Sex Distribution
Chemical
Reg. No./Substance:
34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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