Speckle Tracking Echocardiography and Cardiac Biomarkers in Multi-System Inflammatory Syndrome in Children

Abstract

Abstract Background Cardiac affection in multisystem inflammatory syndrome in children (MIS-C) occurs in ∼80% of patients. Left ventricular (LV) systolic dysfunction is the most frequent finding. Methods In this prospective cohort study, we assessed LV function and cardiac injury in 22 patients with MIS-C using Cardiac biomarkers (Troponin I and CK-MB) and Speckle Tracking Echocardiography. We compare those patients at initial presentation and at 3 months follow up. Results Among the 22 patients with MIS-C cardiac biomarkers (cardiac troponin and CK-MB) showed statistically significant regression on comparing their values at initial presentation and after 10 days follow up (P value <0.01). Ejection fraction was impaired in 43.7%, with a mean value of 52.3% (Range: 32% to 69%). Patients with abnormal strain had a lower EF, more organ system involvement and were more likely to require inotropic support. Lower peak longitudinal strain rates were detected in 59% of MIS-C patients at initial presentation in comparison to follow up assessment 3 months later. Patients with initially depressed function, EF normalized in 21 of 22 patients (95.4%) (P value 0.000), but 5 of 22 (18.1%) of patients had persistently abnormal systolic strain at 3 months follow up (P value 0.817). Conclusion LV systolic dysfunction is common in the acute phase of MIS-C, and detection may be improved with global longitudinal strain assessment. Longitudinal cardiac follow-up is imperative, as patients may be at risk for persistent LV dysfunction.