OBJECTIVETo evaluate the clinical significance of full volume real-time three-dimensional echocardiography (RT-3DE) in the assessment of general and local systolic functions of the left ventricle in children with Kawasaki disease (KD).

METHODSA total of 73 KD children (40 with and 33 without coronary artery lesions) and 35 healthy control children were recruited. Left ventricular ejection fraction (LVEF) was measured by M-mode ultrasound and full volume RT-3DE imaging. A left ventricular volume-time curve and a segmental speed-time curve were generated. Differences between control subjects and patients with and without coronary artery lesions were analyzed.

RESULTSThe M-mode ultrasound measurements of LVEF in KD patients with coronary artery lesions were significantly lower than in KD patients without coronary artery lesions and control children (P<0.05), while there was no significant difference between KD patients without coronary artery lesions and control children. RT-3DE measurements of LVEF were significantly different between the three groups analyzed (P<0.05): coronary artery lesion group < no coronary artery lesion group < control group. RT-3DE-based segmental ventricular wall analysis revealed that Tmsv16-SD and Tmsv12-SD in KD patients with coronary artery lesions were significantly higher than other two groups and Tmsv6-SD was also significantly higher than in the normal control group (P<0.05) and that Tmsv16-SD in KD patients without coronary artery lesions increased significantly compared with the normal control group (P<0.05).

CONCLUSIONSRT-3DE can be used in the quantitative evaluation of the left ventricular function and therefore has significant clinical implications.