Long-term echocardiographic evaluation of cardiac size and function in patients with Kawasaki disease.

The long-term effects of Kawasaki disease on the cardiac function were evaluated in 67 patients. Serial M-mode echocardiograms were obtained at the time of the initial diagnosis, 1 to 3 months, at 3 to 12 months, and at greater than 12 months following the diagnosis. Left ventricular and left atrial dimensions, shortening fraction, left and right ventricular systolic time interval ratios, and computer analysis of digitized echoes of the left ventricular chamber and posterior wall were obtained. The left atrial and left ventricular dimensions were abnormal in half of the patients throughout the study periods. The shortening fraction was abnormal initially but became normal by the end of 3 months. The peak rates of emptying of the left ventricle and thickening of the posterior wall were significantly reduced in all evaluation periods. In addition, the peak rate of diastolic thinning of the posterior wall was reduced, although the peak rate of filling remained normal. Finally, more than 30% of patients studied beyond 12 months had a prolonged major filling and thinning period. There was no difference between patients with or without coronary artery aneurysms. All other systolic and diastolic phase intervals and rates of changes were normal. Contrary to previously published reports, we conclude that patients with Kawasaki disease who do not have demonstrable coronary artery disease, exhibit abnormalities of cardiac chamber size and function long after their acute illness.