Beyond Coronary Artery Lesions, Unmasking Myocardial Abnormalities via Cardiac Magnetic Resonance Imaging in Kawasaki Disease

作者：Lingyi Wen, Zhongqin Zhou, Chuan Wang, Shiganmo Azhe, Kaiyu Zhou, Yingkun Guo · 发表于：Journal of Magnetic Resonance Imaging · 年份：2025 · DOI：10.1002/jmri.29760 · 被引用次数：2 · 研究领域：Kawasaki Disease and Coronary Complications、Coronary Artery Anomalies、Cardiac Structural Anomalies and Repair

Kawasaki disease (KD) is an acute, self-limited febrile illness that can lead to coronary artery (CA) lesions in up to 25% of untreated patients [1]. The global incidence of KD ranges from 20 to 300 cases per 100,000 children, depending on the geographic region [2, 3]. KD incidence has been rising worldwide, and it is the leading cause of acquired heart disease in children in developed countries. Current KD guidelines primarily emphasize the maximum CA Z score and its evolution over time to guide treatment decisions, long-term management, and risk stratification [2, 3]. However, both pathological and in vivo studies have shown that KD also causes widespread myocardial abnormalities, including inflammation, edema, fibrosis, ischemia, and infarction during both the acute and chronic phases [4, 5]. Despite this, there is a lack of comprehensive in vivo evaluations of the natural history of myocardial abnormalities and their clinical implications in KD. The 2024 American Heart Association (AHA) scientific statement on KD highlights this research gap, particularly regarding the optimal timing and imaging modalities for risk stratification and long-term management [2]. Cardiac magnetic resonance imaging (MRI) allows a “one-stop” evaluation of the CA, ventricular structure and function, and myocardial tissue characteristics without radiation or invasive procedures. Cardiac MRI is particularly suitable for comprehensive and longitudinal assessment of both CA lesions and myocardial ab...