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Fukuchi K, Shibutani T, Terakawa Y, Nouno Y, Tateishi E, Onoguchi M, Tetsuya F. Image Quality of Cardiac Silicon Photomultiplier PET/CT Using an Infant Phantom of Extremely Low Birth Weight. J Nucl Med Technol 2024; 52:247-251. [PMID: 38901966 DOI: 10.2967/jnmt.124.267826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 05/16/2024] [Indexed: 06/22/2024] Open
Abstract
The lack of pediatrics-specific equipment for nuclear medicine imaging has resulted in insufficient diagnostic information for newborns, especially low-birth-weight infants. Although PET offers high spatial resolution and low radiation exposure, its use in newborns is limited. This study investigated the feasibility of cardiac PET imaging using the latest silicon photomultiplier (SiPM) PET technology in infants of extremely low birth weight (ELBW) using a phantom model. Methods: The study used a phantom model representing a 500-g ELBW infant with brain, cardiac, liver, and lung tissues. The cardiac tissue included a 3-mm-thick defect mimicking myocardial infarction. Organ tracer concentrations were calculated assuming 18F-FDG myocardial viability scans and 18F-flurpiridaz myocardial perfusion scans and were added to the phantom organs. Imaging was performed using an SiPM PET/CT scanner with a 5-min acquisition. The data acquired in list mode were reconstructed using 3-dimensional ordered-subsets expectation maximization with varying iterations. Image evaluation was based on the depiction of the myocardial defect compared with normal myocardial accumulation. Results: Increasing the number of iterations improved the contrast of the myocardial defect for both tracers, with 18F-flurpiridaz showing higher contrast than 18F-FDG. However, even at 50 iterations, both tracers overestimated the defect accumulation. A bull's-eye image can display the flow metabolism mismatch using images from both tracers. Conclusion: SiPM PET enabled cardiac PET imaging in a 500-g ELBW phantom with a 1-g heart. However, there were limitations in adequately depicting these defects. Considering the image quality and defect contrast,18F-flurpiridaz appears more desirable than 18F-FDG if only one of the two can be used.
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Affiliation(s)
- Kazuki Fukuchi
- Department of Medical Physics and Engineering, Course of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan;
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan; and
| | - Yusuke Terakawa
- Department of Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yoshifumi Nouno
- Department of Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Emi Tateishi
- Department of Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan; and
| | - Fukuda Tetsuya
- Department of Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
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Rajasekaran K, Duraiyarasan S, Adefuye M, Manjunatha N, Ganduri V. Kawasaki Disease and Coronary Artery Involvement: A Narrative Review. Cureus 2022; 14:e28358. [PMID: 36185934 PMCID: PMC9514671 DOI: 10.7759/cureus.28358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 11/25/2022] Open
Abstract
Kawasaki disease is a systemic vasculitis with a risk of developing coronary artery lesions if left untreated. Kawasaki disease can be diagnosed clinically with classical symptoms (conjunctivitis, rash, lymphadenopathy, mucositis, edema of hands and feet), but predicting the risk of developing coronary artery aneurysm remains challenging. The coronary sequelae of Kawasaki disease have significant morbidity and mortality and are the second most common cause of acquired cardiac disease in children. Several genetic and immune factors are involved in the inflammation of coronary artery lesions in Kawasaki disease. Inositol trisphosphate 3-Kinase (ITPKC), Foxp3+, circular RNAs, mannose-binding lectin 2 (MBL2), complement factor H (CFH), kininogen 1 (KNG1), serpin family C member 1 (SERPINC1) and fibronectin 1 (FN1) are the essential genes identified in the pathogenesis of coronary artery lesions in Kawasaki disease. The addition of methylprednisolone to a combination of aspirin and intravenous immunoglobulins and biological agents like anakinra, etanercept, infliximab, and immunosuppressants like cyclosporine prevents the occurrence of coronary artery aneurysms in Kawasaki disease. Since the coronary artery lesions form the second most common cause of acquired cardiac disease in children and the incidence of myocardial infarction is a late complication, the risk stratification for coronary artery aneurysms and follow-up protocols for the prevention of cardiac thrombosis were proposed by the American Heart Association in 2017.
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Moghadam EA, Hamzehlou L, Moazzami B, Mehri M, Ziaee V. Increased QT Interval Dispersion is Associated with Coronary Artery Involvement in Children with
Kawasaki Disease. Oman Med J 2020; 35:e88. [PMID: 31993226 PMCID: PMC6975257 DOI: 10.5001/omj.2020.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/01/2019] [Indexed: 11/03/2022] Open
Abstract
Objectives Coronary artery (CA) involvement is the most well known complication of Kawasaki disease (KD). Previous studies have suggested that QT dispersion has a predictive value in diagnosing cardiac ischemia, ventricular arrhythmia, and sudden cardiac death. However, limited data exits regarding the application of QT dispersion in KD. Therefore, we sought to determine whether there is a relationship between QT dispersion and CA involvement in patients with KD. Methods We performed a cross-sectional study of all consecutive patients with KD who were followed-up at the Pediatric Rheumatology Department (Pediatrics Center of Excellence affiliated to Tehran University of Medical Sciences, Tehran, Iran) from September 2013 to November 2015. Patients who met the criteria for KD, based on the American Heart Association guideline, were enrolled in the study. We collected data regarding patients' demographics, clinical manifestations, laboratory, and echocardiographic findings. Results A total of 70 KD patients were identified, including 43 males (61.4%) and 27 females (38.6%). The median age of patients was 21.0 (11.0-48.0) months. We found statistically significant differences between age, gender, and platelet count among patients with and without CA involvement (p < 0.050). Median corrected QT dispersion in patients with CA involvement calculated from 12 leads in the acute phase was significantly higher compared to the non-CA involvement group (108.0 (89.5-138.5) ms vs. 63.0 (54.0-74.5) ms, respectively (p < 0.001)). Conclusions Prolonged QT dispersion (corrected or non-corrected) during the acute and convalescence phases in patients with KD is associated with coronary involvement.
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Affiliation(s)
- Ehsan Aghaei Moghadam
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran.,Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran
| | - Leila Hamzehlou
- Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran
| | - Bobak Moazzami
- Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran
| | - Mina Mehri
- Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran
| | - Vahid Ziaee
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran.,Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran.,Pediatric Rheumatology Research Group, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Hoshino S, Shimizu C, Jain S, He F, Tremoulet AH, Burns JC. Biomarkers of Inflammation and Fibrosis in Kawasaki Disease Patients Years After Initial Presentation With Low Ejection Fraction. J Am Heart Assoc 2020; 9:e014569. [PMID: 31880981 PMCID: PMC6988139 DOI: 10.1161/jaha.119.014569] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/15/2019] [Indexed: 01/03/2023]
Abstract
Background Coronary artery aneurysms and myocarditis are well-recognized complications of Kawasaki disease (KD) but no systematic evaluation of the consequences of myocarditis has been performed in the subset presenting with low ejection fraction (EF). We postulated that more severe myocardial inflammation as evidenced by low EF during the acute phase could lead to late myocardial fibrosis. Methods and Results We measured the carboxyterminal propeptide of procollagen type I (PIPC), soluble suppressor of tumorigenicity 2, galectin-3 (Gal-3), growth-differentiation factor-15, and calprotectin by ELISA in late convalescent blood samples from 16 KD patients who had an EF ≤55% on their initial echocardiogram. Results were compared with samples from sex- and age-matched KD patients with initial EF >60%. In the univariate analysis, the median Gal-3 and PIPC levels in the low EF group were significantly higher than those in the normal EF group (Gal-3: low EF 6.216 versus normal EF 4.976 mg/dL P=0.038, PIPC: low EF 427.4 versus normal EF 265.2 mg/dL, P=0.01). In a multivariable analysis, there were significant differences for Gal-3 and PIPC levels between the low and normal EF groups, adjusting for age, sex, and worst z score. Conclusions Convalescent KD patients with a history of low EF during the acute illness had significantly elevated levels of Gal-3 and PIPC when compared with matched-control KD patients with normal EF. These findings raise concern for myocardial fibrosis as a potential late sequela of the more severe myocarditis experienced by a subset of KD patients during the acute phase.
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Affiliation(s)
- Shinsuke Hoshino
- Department of PediatricsUniversity of California San Diego School of MedicineLa JollaCA
| | - Chisato Shimizu
- Department of PediatricsUniversity of California San Diego School of MedicineLa JollaCA
| | - Sonia Jain
- Department of Family Medicine and Public HealthUniversity of California San DiegoLa JollaCA
| | - Feng He
- Department of Family Medicine and Public HealthUniversity of California San DiegoLa JollaCA
| | - Adriana H. Tremoulet
- Department of PediatricsUniversity of California San Diego School of MedicineLa JollaCA
- Rady Children's Hospital San DiegoSan DiegoCA
| | - Jane C. Burns
- Department of PediatricsUniversity of California San Diego School of MedicineLa JollaCA
- Rady Children's Hospital San DiegoSan DiegoCA
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Hundeshagen G, Herndon DN, Clayton RP, Wurzer P, McQuitty A, Jennings K, Branski L, Collins VN, Marques NR, Finnerty CC, Suman OE, Kinsky MP. Long-term effect of critical illness after severe paediatric burn injury on cardiac function in adolescent survivors: an observational study. THE LANCET. CHILD & ADOLESCENT HEALTH 2017; 1:293-301. [PMID: 29581998 PMCID: PMC5865217 DOI: 10.1016/s2352-4642(17)30122-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Sepsis, trauma, and burn injury acutely depress systolic and diastolic cardiac function; data on long-term cardiac sequelae of pediatric critical illness are sparse. This study evaluated long-term systolic and diastolic function, myocardial fibrosis, and exercise tolerance in survivors of severe pediatric burn injury. METHODS Subjects at least 5 years after severe burn (post-burn:PB) and age-matched healthy controls (HC) underwent echocardiography to quantify systolic function (ejection fraction[EF%]), diastolic function (E/e'), and myocardial fibrosis (calibrated integrated backscatter) of the left ventricle. Exercise tolerance was quantified by oxygen consumption (VO2) and heart rate at rest and peak exercise. Demographic information, clinical data, and biomarker expression were used to predict long-term cardiac dysfunction and fibrosis. FINDINGS Sixty-five subjects (PB:40;HC:25) were evaluated. At study date, PB subjects were 19±5 years, were at 12±4 years postburn, and had burns over 59±19% of total body surface area, sustained at 8±5 years of age. The PB group had lower EF% (PB:52±9%;HC:61±6%; p=0.004), E/e' (PB:9.8±2.9;HC: 5.4±0.9;p<0.0001), VO2peak (PB:37.9±12;HC: 46±8.32 ml/min/kg; p=0.029), and peak heart rate (PB:161±26;HC:182±13bpm;p=0.007). The PB group had moderate (28%) or severe (15%) systolic dysfunction, moderate (50%) or severe diastolic dysfunction (21%), and myocardial fibrosis (18%). Biomarkers and clinical parameters predicted myocardial fibrosis, systolic dysfunction, and diastolic dysfunction. INTERPRETATION Severe pediatric burn injury may have lasting impact on cardiac function into young adulthood and is associated with myocardial fibrosis and reduced exercise tolerance. Given the strong predictive value of systolic and diastolic dysfunction, these patients might be at increased risk for early heart failure, associated morbidity, and mortality. FUNDING Conflicts of Interest and Sources of Funding: The authors do not have any conflicts of interest to declare. This work was supported by NIH (P50 GM060338, R01 GM056687, R01 HD049471, R01 GM112936, R01-GM56687 and T32 GM008256), NIDILRR (H133A120091, 90DP00430100), Shriners Hospitals for Children (84080, 79141, 79135, 71009, 80100, 71008, 87300 and 71000), FAER (MRTG CON14876), and the Department of Defense (W81XWH-14-2-0162 and W81XWH1420162). It was also made possible with the support of UTMB's Institute for Translational Sciences, supported in part by a Clinical and Translational Science Award (UL1TR000071) from the National Center for Advancing Translational Sciences (NIH).
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Affiliation(s)
- Gabriel Hundeshagen
- Department of Surgery, University of Texas Medical Branch, 301
University Blvd, Galveston, TX 77555
- Shriners Hospitals for Children, Galveston, 815 Market St,
Galveston, TX 77555
- Department of Hand, Plastic and Reconstructive Surgery, Burn Trauma
Center, BG Trauma Center Ludwigshafen; University of Heidelberg,
Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany
| | - David N Herndon
- Department of Surgery, University of Texas Medical Branch, 301
University Blvd, Galveston, TX 77555
- Shriners Hospitals for Children, Galveston, 815 Market St,
Galveston, TX 77555
| | - Robert P Clayton
- Department of Surgery, University of Texas Medical Branch, 301
University Blvd, Galveston, TX 77555
- Shriners Hospitals for Children, Galveston, 815 Market St,
Galveston, TX 77555
| | - Paul Wurzer
- Division of Plastic, Aesthetic and Reconstructive Surgery,
Department of Surgery, Medical University of Graz, Austria
| | - Alexis McQuitty
- Department of Anesthesiology, University of Texas Medical Branch,
301 University Blvd, Galveston, TX 77555
| | - Kristofer Jennings
- Office of Biostatistics, Department of Preventive Medicine and
Community Health, University of Texas Medical Branch, 301 University Blvd,
Galveston, TX 77555
| | - Ludwik Branski
- Department of Surgery, University of Texas Medical Branch, 301
University Blvd, Galveston, TX 77555
- Shriners Hospitals for Children, Galveston, 815 Market St,
Galveston, TX 77555
- Division of Plastic, Aesthetic and Reconstructive Surgery,
Department of Surgery, Medical University of Graz, Austria
| | - Vanessa N Collins
- Shriners Hospitals for Children, Galveston, 815 Market St,
Galveston, TX 77555
| | - Nicole Ribeiro Marques
- Department of Anesthesiology, University of Texas Medical Branch,
301 University Blvd, Galveston, TX 77555
| | - Celeste C Finnerty
- Department of Surgery, University of Texas Medical Branch, 301
University Blvd, Galveston, TX 77555
- Shriners Hospitals for Children, Galveston, 815 Market St,
Galveston, TX 77555
| | - Oscar E Suman
- Department of Surgery, University of Texas Medical Branch, 301
University Blvd, Galveston, TX 77555
- Shriners Hospitals for Children, Galveston, 815 Market St,
Galveston, TX 77555
| | - Michael P Kinsky
- Division of Plastic, Aesthetic and Reconstructive Surgery,
Department of Surgery, Medical University of Graz, Austria
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Telcharova-Mihaylovska A, Nikolova I, Marinov R, Stefanov S, Gaidarova M, Ganeva M, Temelkova K. Kawasaki disease – experience of Pediatric University Hospital, Sofia, Bulgaria, 1993–2014. Part II: cardiovascular manifestations and treatment. BIOTECHNOL BIOTEC EQ 2017. [DOI: 10.1080/13102818.2017.1347522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Albena Telcharova-Mihaylovska
- Clinic of Rheumatology, Pediatric University Hospital SBALDB “Prof. Ivan Mitev”, Medical University of Sofia, Sofia, Bulgaria
| | - Irina Nikolova
- Department of Pharmacology, Pharmacotherapy and Toxicology, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Rumen Marinov
- Department of Pediatric Cardiology, National Cardiology Hospital, Sofia, Bulgaria
| | - Stefan Stefanov
- Clinic of Rheumatology, Pediatric University Hospital SBALDB “Prof. Ivan Mitev”, Medical University of Sofia, Sofia, Bulgaria
| | - Maria Gaidarova
- Clinic of Nephrology, Pediatric University Hospital SBALDB “Prof. Ivan Mitev”, Medical University of Sofia, Sofia, Bulgaria
| | - Margarita Ganeva
- Clinic of Rheumatology, Pediatric University Hospital SBALDB “Prof. Ivan Mitev”, Medical University of Sofia, Sofia, Bulgaria
| | - Katya Temelkova
- Clinic of Rheumatology, Pediatric University Hospital SBALDB “Prof. Ivan Mitev”, Medical University of Sofia, Sofia, Bulgaria
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