The detection of ventricular dysfunction and carditis in children with Kawasaki disease using equilibrium multigated blood pooling ventriculography and 99Tcm-HMPAO-labelled WBC heart scans

Abstract

Thirty-seven children (11 girls, 26 boys; aged 2.8 ± 2.2 years) with Kawasaki disease (KD) were included in the study. The biventricular functions were evaluated by equilibrium multigated blood pooling ventriculography (EMBPV) and the severity of carditis was decided by Tc-hexamethylpropyleneamine oxime (HMPAO) labelled white blood cell (WBC) heart scans (Tc-WBC). The results showed that 43% (16/37) of the KD cases with the severe carditis by Tc-WBC had the worst left ventricular ejection fraction (LVEF) (55.4 ± 15.6%) and right ventricular ejection fraction (RVEF) (43.7% ± 12.2%) by EMBPV; 24% (9/37) of the cases with the mild carditis had the best LVEF (63.5% ± 8.2%) and RVEF (53.7% ± 11.2%); the remaining 32% (12/37) had moderately severe carditis and biventricular function (LVEF: 58.2 ± 17.2% and RVEF: 46.9 ± 19.5%). Because Tc-WBC cannot only detect the severity of carditis but also predict impairment of ventricular function accurately, the choice of Tc-WBC should be preferable for KD — a common inflammatory cardiovascular disease in children.