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Heart and Vessels

, Volume 9, Issue 5, pp 254–262 | Cite as

Myocardial contrast echocardiography of coronary artery lesions due to Kawasaki disease

  • Yoshihisa Kinoshita
  • Atsuko Suzuki
  • Tohru Nakajima
  • Yasuo Ono
  • Yoshio Arakaki
  • Tetsuro Kamiya
  • Shintaro Beppu
Originals

Summary

In addition to coronary arteriography, myocardial contrast echocardiography (MCE) was performed in 25 patients with coronary artery lesions due to Kawasaki disease, in order to investigate its validity in the evaluation of these lesions and its safety in children. The patients' ages ranged from 1.0 to 15.9 years (mean, 8.6 years). Their coronary artery lesions included occlusion in 9 branches (9 patients), segmental stenosis in 9 (8 patients), localized stenosis in 16 (12 patients), and dilated lesions without coexistent stenotic lesions in 5 patients. Seven patients had coronary artery bypass grafts. Myocardial perfusion patterns of the stenotic lesions and coronary artery bypass grafts could be clearly demonstrated by MCE. For the assessment of safety, electrocardiograms obtained at the time of MCE and coronary arteriography in 14 patients showed no significant difference in the findings between MCE and coronary arteriography. Serum glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, lactic dehydrogenase, and creatine phosphokinase levels were measured before and 1 day after the procedure in 14 patients who underwent MCE and coronary arteriography, and in a group of 14 patients who underwent coronary arteriography alone. No significant difference was noted between the values of the two groups. These results suggested that MCE can be utilized in the assessment of coronary artery lesions due to Kawasaki disease, and confirmed the safety of the procedure even in young children.

Key words

Myocardial contrast echocardiography Kawasaki disease Coronary artery lesions 

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References

  1. 1.
    Kabas JS, Kisslo J, Flick CL, Johnson SH, Craig DM, Stanley TE, Smith PK (1990) Intraoperative perfusion contrast echocardiograph. Initial experience during coronary artery bypass grafting. J Thorac Cardiovasc Surg 99:536–542Google Scholar
  2. 2.
    Spotnitz WD, Matthew TL, Keller MW, Powers ER, Kaul S (1990) Intraoperative demonstration of coronary collateral flow using myocardial contrast two-dimensional echocardiography. Am J Cardiol 65:1259–1261Google Scholar
  3. 3.
    Cheirif J, Zoghbi WA, Raizner AE, Minor ST, Wintres WL, Klein MS, De Bauche TL, Lewis JM, Roberts R, Quinones MA (1988) Assessment of myocardial perfusion in humans by contrast echocardiography: I. Evaluation of regional coronary reserve by peak contrast intensity. J Am Coll Cardiol 11:735–743Google Scholar
  4. 4.
    Widimsky P, Cornel JH, TenCate FJ (1988) Evaluation of collateral blood flow by myocardial contrast enhanced echocardiography. Br Heart J 59:20–22Google Scholar
  5. 5.
    Feinstein SB, Lang RM, Dick C, Neumann A, Al-Sadir J, Chua KG, Carroll J, Feldman T, Borow KM (1988) Contrast echocardiography during coronary arteriography in humans: Perfusion and anatomic studies. J Am Coll Cardiol 11:59–65Google Scholar
  6. 6.
    Keller MW, Glasheen W, Smucker ML, Burwell LR, Watson DD, Kaul S (1988) Myocardial contrast echocardiography in humans: II. Assessment of coronary blood flow reserve. J Am Coll Cardiol 12:925–934Google Scholar
  7. 7.
    Lim YJ, Nanto S, Masuyama T, Kodama K, Ikeda T, Kitabatake A, Kamada T (1989) Visualization of subendocardial myocardial ischemia with myocardial contrast echocardiography in humans. Circulation 79:233–244Google Scholar
  8. 8.
    Reisner SA, Ong LS, Lichtenberg GS, Amico AF, Shapiro JR, Allen MN, Meltzer RS (1989) Myocardial perfusion imaging by contrast echocardiography with use of intracoronary sonicated albumin in humans. J Am Coll Cardiol 14:660–665Google Scholar
  9. 9.
    Moore CA, Smucker ML, Kaul S (1986) Myocardial contrast echocardiography in humans: I. Safety — a comparison with routine coronary arteriography. J Am Coll Cardiol 8:1066–1072Google Scholar
  10. 10.
    Kamiya T, Kawasaki T, Okuni M, Kato H, Baba K, Nakano H (1983) Report of subcommittee on standardization of diagnostic criteria and reporting of coronary artery lesions in Kawasaki disease. Ministry of Health and Welfare, Tokyo, Japan, pp 1–5Google Scholar
  11. 11.
    Suzuki A, Kamiya T, Ono Y, Kinoshita Y, Kawamura S, Kimura K (1993) Clinical significance of morphologic classification of coronary arterial segmental stenosis due to Kawasaki disease. Am J Cardiol 71:1169–1173Google Scholar
  12. 12.
    Tei C, Kondou S, Meerbaum S, Ong K, Maurer G, Wood F, Sakamaki T, Shimoura K, Corday E, Shah PM (1984) Correlation of myocardial echo contrast disappearance rate (“washout”) and severity of experimental coronary stenosis. J Am Coll Cardiol 3:39–46Google Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • Yoshihisa Kinoshita
    • 1
  • Atsuko Suzuki
    • 2
  • Tohru Nakajima
    • 2
  • Yasuo Ono
    • 2
  • Yoshio Arakaki
    • 2
  • Tetsuro Kamiya
    • 2
  • Shintaro Beppu
    • 3
  1. 1.Department of CardiologyShizuoka Children's HospitalShizuoka-city, ShizuokaJapan
  2. 2.Department of PediatricsNational Cardiovascular CenterSuita, OsakaJapan
  3. 3.Department of Research InstituteNational Cardiovascular CenterSuita, OsakaJapan

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