Fully Quantitative CMR First-Pass Perfusion Reveals Myocardial Perfusion Impairment in Kawasaki Disease: Association with LV Remodeling

Motivation: Kawasaki disease (KD) is associated with various myocardial injuries, including myocardial perfusion impairment, which is poorly defined. Goal(s): To assess the distribution and determinants of myocardial perfusion impairment in KD using fully quantitative CMR first-pass perfusion and explore their relationships with left ventricular (LV) remodeling. Approach: In a prospective study, 87 children with KD underwent fully quantitative CMR first-pass perfusion. Myocardial blood flow (MBF) was measured and correlated with LV remodeling indicators. Results: Perfusion impairment was prominent in the acute KD phase and mid-giant CAA cases, particularly in the left coronary territory, correlating with decreased LV systolic function and increased LV remodeling. Impact: The study provides further evidence about the usefulness of fully quantitative CMR first-pass perfusion in children. Moreover, the results can contribute to studies that aim to improve the diagnosis and management of myocardial perfusion impairment in children with KD.