Long-term global longitudinal strain abnormalities in paediatric patients after multisystem inflammatory syndrome in children correlate with cardiac troponin T: a single-centre cohort study
Multisystem inflammatory syndrome in children is an inflammatory syndrome related to severe acute respiratory syndrome coronavirus 2 with a high risk of cardiovascular complications (vasoplegia, cardiac shock). We investigated the cardiac outcomes in multisystem inflammatory syndrome in children, fo...
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| Veröffentlicht in: | Cardiology in the young 2024-08, Vol.34 (8), p.1683-1692 |
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| creator | Netea, Stejara A. Biesbroek, Giske Groenink, Maarten Planken, R.N. (Nils) de Winter, Robbert J. Blom, Nico A. Kuijpers, Taco W. Kuipers, Irene M. |
| description | Multisystem inflammatory syndrome in children is an inflammatory syndrome related to severe acute respiratory syndrome coronavirus 2 with a high risk of cardiovascular complications (vasoplegia, cardiac shock). We investigated the cardiac outcomes in multisystem inflammatory syndrome in children, focusing on the identification of predictors for late cardiac function impairment.
Clinical characteristics, conventional echocardiography (left ventricle ejection fraction, fractional shortening), 4-chamber left ventricular global longitudinal strain, and cardiac MRI of multisystem inflammatory syndrome in children patients (n = 48) were collected during admission, 6 weeks, 6 months, >12-≤18 months, and >18-≤24 months post-onset. Paired over-time patterns were assessed and multivariable regression analyses were performed to identify predictors for late global longitudinal strain impairment.
In total, 81.3% of patients had acute cardiac dysfunction (left ventricle ejection fraction 18-≤24 months post-onset. In a multivariable analysis, soluble troponin T (>62.0 ng/L [median]) was associated with reduced global longitudinal strain at 6 months. Our cardiac MRI findings indicated acute myocardial involvement (increased T1/T2 value) in 77.8% (7/9), which recovered quickly without signs of fibrosis on convalescent cardiac MRIs.
Late global longitudinal strain impairment is seen in some multisystem inflammatory syndrome in children patients up to one-year post-onset. Careful cardiac follow-up in patients with elevated troponin in the acute phase and patients with persistent abnormal global longitudinal strain is warranted until resolution of the global longitudinal strain since the long-term implications of such abnormalities are still unclear. |
| doi_str_mv | 10.1017/S1047951124000465 |
| format | Article |
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Clinical characteristics, conventional echocardiography (left ventricle ejection fraction, fractional shortening), 4-chamber left ventricular global longitudinal strain, and cardiac MRI of multisystem inflammatory syndrome in children patients (n = 48) were collected during admission, 6 weeks, 6 months, >12-≤18 months, and >18-≤24 months post-onset. Paired over-time patterns were assessed and multivariable regression analyses were performed to identify predictors for late global longitudinal strain impairment.
In total, 81.3% of patients had acute cardiac dysfunction (left ventricle ejection fraction <50% and/or fractional shortening <28%). The left ventricle ejection fraction and fractional shortening reached a plateau level ≤6 weeks, while the global longitudinal strain continued to decrease in the first 6 months post-onset (median -17.3%,
< 0.001 [versus acute]). At 6 months, 35.7% of the patients still had an abnormal global longitudinal strain, which persisted in 5/9 patients that underwent echocardiography >12-≤18 months post-onset and in 3/3 patients >18-≤24 months post-onset. In a multivariable analysis, soluble troponin T (>62.0 ng/L [median]) was associated with reduced global longitudinal strain at 6 months. Our cardiac MRI findings indicated acute myocardial involvement (increased T1/T2 value) in 77.8% (7/9), which recovered quickly without signs of fibrosis on convalescent cardiac MRIs.
Late global longitudinal strain impairment is seen in some multisystem inflammatory syndrome in children patients up to one-year post-onset. Careful cardiac follow-up in patients with elevated troponin in the acute phase and patients with persistent abnormal global longitudinal strain is warranted until resolution of the global longitudinal strain since the long-term implications of such abnormalities are still unclear.</description><identifier>ISSN: 1047-9511</identifier><identifier>ISSN: 1467-1107</identifier><identifier>EISSN: 1467-1107</identifier><identifier>DOI: 10.1017/S1047951124000465</identifier><identifier>PMID: 38584315</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Abnormalities ; Adolescent ; Aneurysms ; Cardiovascular diseases ; Child ; Child, Preschool ; Children ; Cohort analysis ; Cohort Studies ; Coronary vessels ; Coronaviruses ; COVID-19 - blood ; COVID-19 - complications ; Echocardiography ; Echocardiography and Scans ; Ejection fraction ; Female ; Fibrosis ; Global Longitudinal Strain ; Humans ; Impairment ; Infant ; Inflammation ; Kawasaki disease ; Laboratories ; Magnetic Resonance Imaging ; Male ; Multisystem inflammatory syndrome in children ; Myocarditis ; Original Article ; Outpatient care facilities ; Patients ; Pediatrics ; Regression analysis ; Respiratory diseases ; SARS-CoV-2 ; Severe acute respiratory syndrome ; Severe acute respiratory syndrome coronavirus 2 ; Strain analysis ; Stroke Volume ; Systemic Inflammatory Response Syndrome - blood ; Systemic Inflammatory Response Syndrome - diagnosis ; Troponin ; Troponin T ; Troponin T - blood ; Ultrasonic imaging ; Ventricles (cerebral) ; Ventricular Dysfunction, Left - blood ; Ventricular Dysfunction, Left - diagnostic imaging ; Ventricular Dysfunction, Left - etiology ; Ventricular Dysfunction, Left - physiopathology</subject><ispartof>Cardiology in the young, 2024-08, Vol.34 (8), p.1683-1692</ispartof><rights>Amsterdam UMC, location AMC, 2024. Published by Cambridge University Press</rights><rights>Amsterdam UMC, location AMC, 2024. Published by Cambridge University Press. This work is licensed under the Creative Commons Attribution License This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c368t-f24001b278b7fde5182603d01068b88d52ebf46e71e2f1e073f622bde5d0783f3</cites><orcidid>0000-0002-3495-4705</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S1047951124000465/type/journal_article$$EHTML$$P50$$Gcambridge$$Hfree_for_read</linktohtml><link.rule.ids>164,314,780,784,27924,27925,55628</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38584315$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Netea, Stejara A.</creatorcontrib><creatorcontrib>Biesbroek, Giske</creatorcontrib><creatorcontrib>Groenink, Maarten</creatorcontrib><creatorcontrib>Planken, R.N. (Nils)</creatorcontrib><creatorcontrib>de Winter, Robbert J.</creatorcontrib><creatorcontrib>Blom, Nico A.</creatorcontrib><creatorcontrib>Kuijpers, Taco W.</creatorcontrib><creatorcontrib>Kuipers, Irene M.</creatorcontrib><creatorcontrib>Kawasaki Study Group</creatorcontrib><creatorcontrib>Kawasaki Study Group</creatorcontrib><title>Long-term global longitudinal strain abnormalities in paediatric patients after multisystem inflammatory syndrome in children correlate with cardiac troponin T: a single-centre cohort study</title><title>Cardiology in the young</title><addtitle>Cardiol Young</addtitle><description>Multisystem inflammatory syndrome in children is an inflammatory syndrome related to severe acute respiratory syndrome coronavirus 2 with a high risk of cardiovascular complications (vasoplegia, cardiac shock). We investigated the cardiac outcomes in multisystem inflammatory syndrome in children, focusing on the identification of predictors for late cardiac function impairment.
Clinical characteristics, conventional echocardiography (left ventricle ejection fraction, fractional shortening), 4-chamber left ventricular global longitudinal strain, and cardiac MRI of multisystem inflammatory syndrome in children patients (n = 48) were collected during admission, 6 weeks, 6 months, >12-≤18 months, and >18-≤24 months post-onset. Paired over-time patterns were assessed and multivariable regression analyses were performed to identify predictors for late global longitudinal strain impairment.
In total, 81.3% of patients had acute cardiac dysfunction (left ventricle ejection fraction <50% and/or fractional shortening <28%). The left ventricle ejection fraction and fractional shortening reached a plateau level ≤6 weeks, while the global longitudinal strain continued to decrease in the first 6 months post-onset (median -17.3%,
< 0.001 [versus acute]). At 6 months, 35.7% of the patients still had an abnormal global longitudinal strain, which persisted in 5/9 patients that underwent echocardiography >12-≤18 months post-onset and in 3/3 patients >18-≤24 months post-onset. In a multivariable analysis, soluble troponin T (>62.0 ng/L [median]) was associated with reduced global longitudinal strain at 6 months. Our cardiac MRI findings indicated acute myocardial involvement (increased T1/T2 value) in 77.8% (7/9), which recovered quickly without signs of fibrosis on convalescent cardiac MRIs.
Late global longitudinal strain impairment is seen in some multisystem inflammatory syndrome in children patients up to one-year post-onset. Careful cardiac follow-up in patients with elevated troponin in the acute phase and patients with persistent abnormal global longitudinal strain is warranted until resolution of the global longitudinal strain since the long-term implications of such abnormalities are still unclear.</description><subject>Abnormalities</subject><subject>Adolescent</subject><subject>Aneurysms</subject><subject>Cardiovascular diseases</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Coronary vessels</subject><subject>Coronaviruses</subject><subject>COVID-19 - blood</subject><subject>COVID-19 - complications</subject><subject>Echocardiography</subject><subject>Echocardiography and Scans</subject><subject>Ejection fraction</subject><subject>Female</subject><subject>Fibrosis</subject><subject>Global Longitudinal Strain</subject><subject>Humans</subject><subject>Impairment</subject><subject>Infant</subject><subject>Inflammation</subject><subject>Kawasaki disease</subject><subject>Laboratories</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Multisystem inflammatory syndrome in children</subject><subject>Myocarditis</subject><subject>Original Article</subject><subject>Outpatient care facilities</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Regression analysis</subject><subject>Respiratory diseases</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Strain analysis</subject><subject>Stroke Volume</subject><subject>Systemic Inflammatory Response Syndrome - blood</subject><subject>Systemic Inflammatory Response Syndrome - diagnosis</subject><subject>Troponin</subject><subject>Troponin T</subject><subject>Troponin T - blood</subject><subject>Ultrasonic imaging</subject><subject>Ventricles (cerebral)</subject><subject>Ventricular Dysfunction, Left - blood</subject><subject>Ventricular Dysfunction, Left - diagnostic imaging</subject><subject>Ventricular Dysfunction, Left - etiology</subject><subject>Ventricular Dysfunction, Left - physiopathology</subject><issn>1047-9511</issn><issn>1467-1107</issn><issn>1467-1107</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>IKXGN</sourceid><sourceid>EIF</sourceid><recordid>eNp1kd-K1TAQxoso7h99AG8k4I031UzTNlnvZFFXOOCF63VJm8k5WZLmmKQsfTjfzSl7VFC8ymTm930T8lXVC-BvgIN8-xV4K686gKblnLd996g6h7aXNQCXj6mmcb3Nz6qLnO84ByGAP63OhOpUK6A7r37s4ryvC6bA9j6O2jNPDVcW42a65JK0m5ke55iC9q44zIwaR43G6ZLcRCU155KZtmTDwuKLy2suGAi0XoegS0wry-tsUgy4yaeD8yYhFTEl9Logu3flwCadyHZiJcVjnAm8fcc0y27ee6wn2pKQJIeYCr1sMeuz6onVPuPz03lZffv44fb6pt59-fT5-v2unkSvSm23_4GxkWqU1mAHqum5MBx4r0alTNfgaNseJWBjAbkUtm-akUjDpRJWXFavH3yPKX5fMJchuDyh93rGuORBcNFK2aq-JfTVX-hdXBL9JVFbTgBw1RAFD9SUYs4J7XBMLui0DsCHLdvhn2xJ8_LkvIwBzW_FrzAJECdTHcbkzB7_7P6_7U9j0LKJ</recordid><startdate>20240801</startdate><enddate>20240801</enddate><creator>Netea, Stejara A.</creator><creator>Biesbroek, Giske</creator><creator>Groenink, Maarten</creator><creator>Planken, R.N. (Nils)</creator><creator>de Winter, Robbert J.</creator><creator>Blom, Nico A.</creator><creator>Kuijpers, Taco W.</creator><creator>Kuipers, Irene M.</creator><general>Cambridge University Press</general><scope>IKXGN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3495-4705</orcidid></search><sort><creationdate>20240801</creationdate><title>Long-term global longitudinal strain abnormalities in paediatric patients after multisystem inflammatory syndrome in children correlate with cardiac troponin T: a single-centre cohort study</title><author>Netea, Stejara A. ; Biesbroek, Giske ; Groenink, Maarten ; Planken, R.N. 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(Nils)</creatorcontrib><creatorcontrib>de Winter, Robbert J.</creatorcontrib><creatorcontrib>Blom, Nico A.</creatorcontrib><creatorcontrib>Kuijpers, Taco W.</creatorcontrib><creatorcontrib>Kuipers, Irene M.</creatorcontrib><creatorcontrib>Kawasaki Study Group</creatorcontrib><creatorcontrib>Kawasaki Study Group</creatorcontrib><collection>Cambridge Open Access Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Cardiology in the young</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Netea, Stejara A.</au><au>Biesbroek, Giske</au><au>Groenink, Maarten</au><au>Planken, R.N. (Nils)</au><au>de Winter, Robbert J.</au><au>Blom, Nico A.</au><au>Kuijpers, Taco W.</au><au>Kuipers, Irene M.</au><aucorp>Kawasaki Study Group</aucorp><aucorp>Kawasaki Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term global longitudinal strain abnormalities in paediatric patients after multisystem inflammatory syndrome in children correlate with cardiac troponin T: a single-centre cohort study</atitle><jtitle>Cardiology in the young</jtitle><addtitle>Cardiol Young</addtitle><date>2024-08-01</date><risdate>2024</risdate><volume>34</volume><issue>8</issue><spage>1683</spage><epage>1692</epage><pages>1683-1692</pages><issn>1047-9511</issn><issn>1467-1107</issn><eissn>1467-1107</eissn><abstract>Multisystem inflammatory syndrome in children is an inflammatory syndrome related to severe acute respiratory syndrome coronavirus 2 with a high risk of cardiovascular complications (vasoplegia, cardiac shock). We investigated the cardiac outcomes in multisystem inflammatory syndrome in children, focusing on the identification of predictors for late cardiac function impairment.
Clinical characteristics, conventional echocardiography (left ventricle ejection fraction, fractional shortening), 4-chamber left ventricular global longitudinal strain, and cardiac MRI of multisystem inflammatory syndrome in children patients (n = 48) were collected during admission, 6 weeks, 6 months, >12-≤18 months, and >18-≤24 months post-onset. Paired over-time patterns were assessed and multivariable regression analyses were performed to identify predictors for late global longitudinal strain impairment.
In total, 81.3% of patients had acute cardiac dysfunction (left ventricle ejection fraction <50% and/or fractional shortening <28%). The left ventricle ejection fraction and fractional shortening reached a plateau level ≤6 weeks, while the global longitudinal strain continued to decrease in the first 6 months post-onset (median -17.3%,
< 0.001 [versus acute]). At 6 months, 35.7% of the patients still had an abnormal global longitudinal strain, which persisted in 5/9 patients that underwent echocardiography >12-≤18 months post-onset and in 3/3 patients >18-≤24 months post-onset. In a multivariable analysis, soluble troponin T (>62.0 ng/L [median]) was associated with reduced global longitudinal strain at 6 months. Our cardiac MRI findings indicated acute myocardial involvement (increased T1/T2 value) in 77.8% (7/9), which recovered quickly without signs of fibrosis on convalescent cardiac MRIs.
Late global longitudinal strain impairment is seen in some multisystem inflammatory syndrome in children patients up to one-year post-onset. Careful cardiac follow-up in patients with elevated troponin in the acute phase and patients with persistent abnormal global longitudinal strain is warranted until resolution of the global longitudinal strain since the long-term implications of such abnormalities are still unclear.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>38584315</pmid><doi>10.1017/S1047951124000465</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-3495-4705</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Abnormalities Adolescent Aneurysms Cardiovascular diseases Child Child, Preschool Children Cohort analysis Cohort Studies Coronary vessels Coronaviruses COVID-19 - blood COVID-19 - complications Echocardiography Echocardiography and Scans Ejection fraction Female Fibrosis Global Longitudinal Strain Humans Impairment Infant Inflammation Kawasaki disease Laboratories Magnetic Resonance Imaging Male Multisystem inflammatory syndrome in children Myocarditis Original Article Outpatient care facilities Patients Pediatrics Regression analysis Respiratory diseases SARS-CoV-2 Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 Strain analysis Stroke Volume Systemic Inflammatory Response Syndrome - blood Systemic Inflammatory Response Syndrome - diagnosis Troponin Troponin T Troponin T - blood Ultrasonic imaging Ventricles (cerebral) Ventricular Dysfunction, Left - blood Ventricular Dysfunction, Left - diagnostic imaging Ventricular Dysfunction, Left - etiology Ventricular Dysfunction, Left - physiopathology |
| title | Long-term global longitudinal strain abnormalities in paediatric patients after multisystem inflammatory syndrome in children correlate with cardiac troponin T: a single-centre cohort study |
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