Background

Short-term sequelae of Multisystem Inflammatory Syndrome in Children (MIS-C), recently published by our institution, showed rapid improvement of the cardiac abnormalities within a few weeks after the onset of the disease. However, subtle residual abnormalities, affecting mainly the myocardial interstitium, were shown in some of the patients. The current study aimed to assess myocardial deformation with CMR shortly after MIS-C.

Methods

Sixty children were included into the study; 30 following MIS-C (onset-to-scan mean 27 days, SD 11) and 30 controls. Strain values were compared between patients and controls and additionally to published paediatric normal CMR values. U-Mann Whitney test was used for comparison of the myocardial deformation between patients and controls.

Results

Median age of the patients was 9.0 years (range 0.99–14.4) and controls 9.8 years (range 4.7–14.9). All conventional CMR parameters in patients were in normal range. Strain values were significantly lower in patients than in controls. When compared to published centile graphs, radial and circumferential global strain was within 2.5th and 97.5th centile in all patients. Eleven patients had global longitudinal strain between 2.5th centile and 50th centile, 1 patient was below 2.5th centile and all the others above 50th centile. Only 3 controls had global longitudinal strain between 2.5th centile and 50th centile, all other had higher strain.

Conclusions

This study demonstrates that myocardial deformation indices measured by CMR are within normal range in the vast majority of the patients within a few weeks after the onset of MIS-C. However, when compared to healthy controls, all strain parameters were lower in patients.

中文翻译：

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CMR 评估多系统炎症综合征 (MIS-C) 后儿童心肌变形

背景

我院近期发表的儿童多系统炎症综合征（MIS-C）短期后遗症显示，发病后数周内心脏异常情况迅速改善。然而，在一些患者中显示出主要影响心肌间质的细微残留异常。目前的研究旨在评估 MIS-C 后不久的 CMR 心肌变形。

方法

60名儿童被纳入研究；30 名 MIS-C（开始扫描平均 27 天，标准差 11）和 30 名对照。应变值在患者和对照组之间进行了比较，此外还与公布的儿科正常 CMR 值进行了比较。U-Mann Whitney 检验用于比较患者和对照组之间的心肌变形。

结果

患者的中位年龄为 9.0 岁（范围 0.99-14.4），对照组为 9.8 岁（范围 4.7-14.9）。患者的所有常规 CMR 参数均在正常范围内。患者的应变值显着低于对照组。与已发表的百分位图相比，所有患者的径向和周向全局应变均在 2.5 和 97.5 百分位范围内。11 名患者的整体纵向应变在 2.5 至 50 百分位之间，1 名患者低于 2.5 百分位，其余患者均高于 50 百分位。只有 3 个对照的全局纵向应变在 2.5 和 50 百分之间，其他所有的都具有更高的应变。

结论

本研究表明，在 MIS-C 发作后的几周内，绝大多数患者的 CMR 测量的心肌变形指数均在正常范围内。然而，与健康对照组相比，患者的所有应变参数均较低。