Early Echocardiographic and Cardiac MRI Findings in Multisystem Inflammatory Syndrome in Children
Multisystem Inflammatory Syndrome in Children (MIS-C) is a known severe condition affecting children previously exposed to SARS-CoV-2. The aim of our study was to describe the early cardiac abnormalities in patients with MIS-C, evaluated by speckle tracking echocardiography (STE) and cardiac MRI (CM...
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MDPI AG
2021-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/15/3360 |
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| author | Domenico Sirico Alessia Basso Elena Reffo Annachiara Cavaliere Biagio Castaldi Jolanda Sabatino Alessandra Meneghel Giorgia Martini Liviana Da Dalt Francesco Zulian Giovanni Di Salvo |
| author_facet | Domenico Sirico Alessia Basso Elena Reffo Annachiara Cavaliere Biagio Castaldi Jolanda Sabatino Alessandra Meneghel Giorgia Martini Liviana Da Dalt Francesco Zulian Giovanni Di Salvo |
| author_sort | Domenico Sirico |
| collection | DOAJ |
| description | Multisystem Inflammatory Syndrome in Children (MIS-C) is a known severe condition affecting children previously exposed to SARS-CoV-2. The aim of our study was to describe the early cardiac abnormalities in patients with MIS-C, evaluated by speckle tracking echocardiography (STE) and cardiac MRI (CMR). Clinical, laboratory and microbiological data were measured for all patients. All children underwent standard transthoracic echocardiography, STE with analysis of left ventricle global longitudinal strain (GLS). Seventeen (75%) of the children were evaluated with CMR. Twenty-three patients (13M, 10F) were recruited, mean age was 8.1 ± 4 years. Cardiovascular symptoms were present in 10 (43.5%). Nine children (39.1%) shared Kawasaki Disease-like symptoms. Four patients (17.4%) needed ICU admission. In-hospital survival was 100%. TnI was elevated in 15 (65.2%) and BNP in 20 (86.9%) patients. The median time to STE evaluation was 8 days and to CMR was 18 days after fever onset. Mean LVEF was 59 ± 10%. Coronary dilation was observed in six (26.1%) patients. STE showed a reduced mean LVGLS (−17 ± 4.3%). LGE with a non-ischemic pattern was evident in six out of seventeen patients (35.2%). The elevation of myocardial necrosis markers, the reduction of LVGLS and the presence of LGE on CMR in about a quarter of MIS-C patients supports the hypothesis of a post-viral immune-mediated myocarditis-like pathogenesis. |
| first_indexed | 2024-03-10T09:13:07Z |
| format | Article |
| id | doaj.art-8e682ff62ece4abc965628c2d4e1db33 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T09:13:07Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-8e682ff62ece4abc965628c2d4e1db332023-11-22T05:49:36ZengMDPI AGJournal of Clinical Medicine2077-03832021-07-011015336010.3390/jcm10153360Early Echocardiographic and Cardiac MRI Findings in Multisystem Inflammatory Syndrome in ChildrenDomenico Sirico0Alessia Basso1Elena Reffo2Annachiara Cavaliere3Biagio Castaldi4Jolanda Sabatino5Alessandra Meneghel6Giorgia Martini7Liviana Da Dalt8Francesco Zulian9Giovanni Di Salvo10Pediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, 35128 Padua, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, 35128 Padua, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, 35128 Padua, ItalyInstitute of Radiology, University Hospital of Padova, 35128 Padua, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, 35128 Padua, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, 35128 Padua, ItalyPediatric Rheumatology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, 35128 Padua, ItalyPediatric Rheumatology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, 35128 Padua, ItalyPediatric Emergency Unit, Department for Women’s and Children’s Health, University Hospital of Padova, 35128 Padua, ItalyPediatric Rheumatology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, 35128 Padua, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, 35128 Padua, ItalyMultisystem Inflammatory Syndrome in Children (MIS-C) is a known severe condition affecting children previously exposed to SARS-CoV-2. The aim of our study was to describe the early cardiac abnormalities in patients with MIS-C, evaluated by speckle tracking echocardiography (STE) and cardiac MRI (CMR). Clinical, laboratory and microbiological data were measured for all patients. All children underwent standard transthoracic echocardiography, STE with analysis of left ventricle global longitudinal strain (GLS). Seventeen (75%) of the children were evaluated with CMR. Twenty-three patients (13M, 10F) were recruited, mean age was 8.1 ± 4 years. Cardiovascular symptoms were present in 10 (43.5%). Nine children (39.1%) shared Kawasaki Disease-like symptoms. Four patients (17.4%) needed ICU admission. In-hospital survival was 100%. TnI was elevated in 15 (65.2%) and BNP in 20 (86.9%) patients. The median time to STE evaluation was 8 days and to CMR was 18 days after fever onset. Mean LVEF was 59 ± 10%. Coronary dilation was observed in six (26.1%) patients. STE showed a reduced mean LVGLS (−17 ± 4.3%). LGE with a non-ischemic pattern was evident in six out of seventeen patients (35.2%). The elevation of myocardial necrosis markers, the reduction of LVGLS and the presence of LGE on CMR in about a quarter of MIS-C patients supports the hypothesis of a post-viral immune-mediated myocarditis-like pathogenesis.https://www.mdpi.com/2077-0383/10/15/3360multisystem inflammatory syndrome in childrenCOVID 19speckle tracking echocardiographylongitudinal straincardiac magnetic resonancemyocardial injury |
| spellingShingle | Domenico Sirico Alessia Basso Elena Reffo Annachiara Cavaliere Biagio Castaldi Jolanda Sabatino Alessandra Meneghel Giorgia Martini Liviana Da Dalt Francesco Zulian Giovanni Di Salvo Early Echocardiographic and Cardiac MRI Findings in Multisystem Inflammatory Syndrome in Children Journal of Clinical Medicine multisystem inflammatory syndrome in children COVID 19 speckle tracking echocardiography longitudinal strain cardiac magnetic resonance myocardial injury |
| title | Early Echocardiographic and Cardiac MRI Findings in Multisystem Inflammatory Syndrome in Children |
| title_full | Early Echocardiographic and Cardiac MRI Findings in Multisystem Inflammatory Syndrome in Children |
| title_fullStr | Early Echocardiographic and Cardiac MRI Findings in Multisystem Inflammatory Syndrome in Children |
| title_full_unstemmed | Early Echocardiographic and Cardiac MRI Findings in Multisystem Inflammatory Syndrome in Children |
| title_short | Early Echocardiographic and Cardiac MRI Findings in Multisystem Inflammatory Syndrome in Children |
| title_sort | early echocardiographic and cardiac mri findings in multisystem inflammatory syndrome in children |
| topic | multisystem inflammatory syndrome in children COVID 19 speckle tracking echocardiography longitudinal strain cardiac magnetic resonance myocardial injury |
| url | https://www.mdpi.com/2077-0383/10/15/3360 |
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