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Predictors of coronary artery visualization in Kawasaki disease.

Publication ,  Journal Article
Margossian, R; Lu, M; Minich, LL; Bradley, TJ; Cohen, MS; Li, JS; Printz, BF; Shirali, GS; Sleeper, LA; Newburger, JW; Colan, SD ...
Published in: J Am Soc Echocardiogr
January 2011

BACKGROUND: Echocardiography is the imaging modality of choice for the evaluation of coronary artery (CA) abnormalities in Kawasaki disease. Small series have established high specificity and sensitivity for detecting abnormalities, yet visualization rates of individual CA segments and factors associated with success are unknown. METHODS: In the Pediatric Heart Network's randomized trial of primary steroid treatment for Kawasaki disease, echocardiograms were interpreted locally and by a core laboratory. Univariate and multivariate predictors of CA visualization by the local lab as determined by the core lab were explored, and agreement of CA size measured locally and by the core lab was assessed. RESULTS: A total of 589 echocardiograms from 199 patients were obtained over 27 months. Visualization rates for the left main, proximal and distal left anterior descending, and proximal right CAs ranged from 91% to 98% but were lower for the distal right (65%), circumflex (86%), and posterior descending (54%) CAs. For the distal right and circumflex CAs, visualization rates improved over the course of the study (P<.05). In multivariate analysis, local center, CA segment, and time from study start to echocardiography were independent predictors of visualization (all P values<.001). For segments for which visualization rates varied by center, higher percentage visualization was associated with larger center volume (P=.001). Routine sedation use was also associated with higher visualization rates. CONCLUSIONS: Successful CA visualization in Kawasaki disease is associated with the segment being evaluated and is influenced by center volume and sedation use. Increased visualization rates over time suggest a learning curve and underscore the value of core lab oversight in pediatric multicenter trials.

Duke Scholars

Published In

J Am Soc Echocardiogr

DOI

EISSN

1097-6795

Publication Date

January 2011

Volume

24

Issue

1

Start / End Page

53 / 59

Location

United States

Related Subject Headings

  • United States
  • Sensitivity and Specificity
  • Risk Factors
  • Risk Assessment
  • Reproducibility of Results
  • Mucocutaneous Lymph Node Syndrome
  • Male
  • Incidence
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Margossian, R., Lu, M., Minich, L. L., Bradley, T. J., Cohen, M. S., Li, J. S., … Pediatric Heart Network Investigators, . (2011). Predictors of coronary artery visualization in Kawasaki disease. J Am Soc Echocardiogr, 24(1), 53–59. https://doi.org/10.1016/j.echo.2010.10.015
Margossian, Renee, Minmin Lu, L LuAnn Minich, Timothy J. Bradley, Meryl S. Cohen, Jennifer S. Li, Beth F. Printz, et al. “Predictors of coronary artery visualization in Kawasaki disease.J Am Soc Echocardiogr 24, no. 1 (January 2011): 53–59. https://doi.org/10.1016/j.echo.2010.10.015.
Margossian R, Lu M, Minich LL, Bradley TJ, Cohen MS, Li JS, et al. Predictors of coronary artery visualization in Kawasaki disease. J Am Soc Echocardiogr. 2011 Jan;24(1):53–9.
Margossian, Renee, et al. “Predictors of coronary artery visualization in Kawasaki disease.J Am Soc Echocardiogr, vol. 24, no. 1, Jan. 2011, pp. 53–59. Pubmed, doi:10.1016/j.echo.2010.10.015.
Margossian R, Lu M, Minich LL, Bradley TJ, Cohen MS, Li JS, Printz BF, Shirali GS, Sleeper LA, Newburger JW, Colan SD, Pediatric Heart Network Investigators. Predictors of coronary artery visualization in Kawasaki disease. J Am Soc Echocardiogr. 2011 Jan;24(1):53–59.
Journal cover image

Published In

J Am Soc Echocardiogr

DOI

EISSN

1097-6795

Publication Date

January 2011

Volume

24

Issue

1

Start / End Page

53 / 59

Location

United States

Related Subject Headings

  • United States
  • Sensitivity and Specificity
  • Risk Factors
  • Risk Assessment
  • Reproducibility of Results
  • Mucocutaneous Lymph Node Syndrome
  • Male
  • Incidence
  • Humans
  • Female