Abstract：
The most significant sequelae of Kawasaki disease (KD) are coronary artery aneurysms, which can lead to risk of future myocardial ischemia. Exercise stress echocardiography allows for non-invasive assessment of myocardial dysfunction. We reviewed our single center experience with exercise stress echocardiography in patients with previous history of KD with coronary aneurysms. We reviewed the records of 53 KD patients who underwent exercise stress echocardiography from 2000 to 2020. Abnormal stress echocardiograms were defined as those showing no increase in biventricular systolic function post-exercise or regional wall motion abnormalities. Computed tomography angiography and cardiac magnetic resonance imaging were reviewed for patients with abnormal stress echocardiograms. Clinical data were reviewed and correlated with stress echocardiogram results. Of the 53 patients, three (5.7%) had an abnormal exercise stress echocardiogram. All three patients were classified as AHA Risk Level 4 or 5 by coronary Z-score (internal dimension normalized for body surface area) and were confirmed to have coronary aneurysms, stenosis, or myocardial tissue perfusion defects on advanced cardiac imaging that could account for the results seen on stress echocardiogram. Exercise stress echocardiography detected signs of myocardial ischemia in a subset of high-risk patients with Kawasaki disease and coronary aneurysms and may be considered as a useful screening tool for this complex patient cohort.
摘要：
川崎病（KD）最重要的后遗症是冠状动脉瘤，这可能导致未来心肌缺血的风险。运动负荷超声心动图可以对心肌功能障碍进行非侵入性评估。我们回顾了我们的单中心在运动负荷超声心动图方面的经验。我们回顾了2000年至2020年进行运动负荷超声心动图检查的53例KD患者的记录。异常压力超声心动图定义为运动后双心室收缩功能没有增加或局部壁运动异常。对压力超声心动图异常的患者进行了计算机断层扫描血管造影和心脏磁共振成像。对临床数据进行审查，并与压力超声心动图结果相关。在53名患者中，3人（5.7％）的运动压力超声心动图异常。所有3例患者均通过冠状动脉Z评分（针对体表面积进行归一化的内部尺寸）被分类为AHA风险等级4或5，并被证实患有冠状动脉瘤。狭窄,或高级心脏成像上的心肌组织灌注缺陷，这可以解释在压力超声心动图上看到的结果。运动负荷超声心动图在川崎病和冠状动脉瘤的高危患者亚组中检测到心肌缺血的迹象，可以被认为是该复杂患者队列的有用筛查工具。
