Evidence map›Paper›PMID 41638925›Full record

ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance

Prognostic value of stress perfusion cardiac magnetic resonance imaging in Kawasaki disease with coronary artery aneurysms: A 10-year retrospective cohort study.

Alexander J Kiener, S Kristen Sexson Tejtel, Aimee Liou, Carolyn A Altman, Tam T Doan

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Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Alexander J KienerDivision of Cardiology, Texas Children's Hospital, Houston, Texas, USA; Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. Electronic address: alexander.kiener@bcm.edu.
S Kristen Sexson TejtelDivision of Cardiology, Texas Children's Hospital, Houston, Texas, USA; Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Aimee LiouDivision of Cardiology, Texas Children's Hospital, Houston, Texas, USA; Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Carolyn A AltmanDivision of Cardiology, Texas Children's Hospital, Houston, Texas, USA; Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Tam T DoanDivision of Cardiology, Texas Children's Hospital, Houston, Texas, USA; Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. Electronic address: tam.doan@bcm.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKawasaki disease (KD) with coronary artery aneurysms (CAA) places patients at risk for myocardial ischemia and major cardiac events (MCE). While stress perfusion cardiac magnetic resonance imaging (spCMR) is used for surveillance, its prognostic value has not been established.

methodsWe conducted a retrospective cohort study of KD patients (AHA risk levels 3-5) who underwent clinically indicated vasodilator spCMR at a tertiary pediatric center between October 2014 and December 2024. We evaluated inducible perfusion defects, late gadolinium enhancement (LGE), ventricular function, and MCE (myocardial infarction, ventricular dysfunction, arrhythmia, revascularization, transplant, or death). We performed Cox regression and Kaplan-Meier analyses to evaluate risk factors associated with MCE.

resultsAbout 62 patients underwent 107 spCMR examinations. Over a median follow-up of 8.6 years (IQR 5.9-12.1) from KD diagnosis, 18 patients (29.0%) experienced an MCE, all of whom were AHA risk level 5. Nine patients developed MCEs after their first spCMR, and inducible perfusion defects on that initial study were associated with higher risk of subsequent events (HR 4.2, 95% CI 1.1-15.6; p=0.03). Among the 44 AHA risk level 5 patients, inducible perfusion defects occurred in 13 (29.5%), who had a higher incidence of subsequent MCE (44.4% vs. 14.3%, p = 0.045); among those with both significant luminal narrowing and positive spCMR, 64% developed MCE. Serial spCMR identified new inducible defects in patients who later experienced MCE. In six patients, post-operative spCMR helped assess revascularization adequacy and return-to-activity decisions.

conclusionsIn KD patients with CAA, inducible perfusion defects on spCMR were associated with increased MCE risk, whereas a normal spCMR in AHA risk levels 3-4 was reassuring. Serial spCMR identified evolving ischemia, guided revascularization decisions, and informed post-intervention management. These findings support the incorporating spCMR into longitudinal surveillance pathway for high-risk KD patients.

Indexed as

Coronary AneurysmCoronary CirculationMucocutaneous Lymph Node SyndromeMyocardial Perfusion ImagingChildChild, PreschoolFemaleHumansInfantMalePerfusion Magnetic Resonance ImagingPredictive Value of TestsPrognosisRetrospective StudiesRisk AssessmentRisk FactorsVasodilator AgentsCoronary artery aneurysmCoronary revascularizationKawasaki diseaseMyocardial ischemiaPediatric cardiologyStress perfusion cardiac MRI

Identifiers

PMID41638925
PMCPMC13265422

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.