Abstract
Multisystem Inflammatory Syndrome in Children (MIS-C) often involves a post-viral myocarditis and associated left ventricular dysfunction. We aimed to assess myocardial function by strain echocardiography after hospital discharge and to identify risk factors for subacute myocardial dysfunction. We conducted a retrospective single-center study of MIS-C patients admitted between 03/2020 and 03/2021. Global longitudinal strain (GLS), 4-chamber longitudinal strain (4C-LS), mid-ventricular circumferential strain (CS), and left atrial strain (LAS) were measured on echocardiograms performed 3-10 weeks after discharge and compared with controls. Among 60 MIS-C patients, hypotension (65%), ICU admission (57%), and vasopressor support (45%) were common, with no mortality. LVEF was abnormal (< 55%) in 29 during hospitalization but only 4 at follow-up. follow-up strain abnormalities were prevalent gls abnormal in 13 4c-ls in 18 cs in 16 las in 5. hypotension icu admission icu and hospital length of stay and any lvef>< 55% during hospitalization were factors associated with lower strain at follow-up. higher peak c-reactive protein crp was associated with hypotension icu admission total icu days and with lower follow-up gls r=" - 0.55;" p=" 0.01)" and cs r=" 0.41;" p=" 0.02)." peak crp>< 18 mg dl had negative predictive values of 100 and 88 for normal follow-up gls and cs respectively. a subset of mis-c patients demonstrate subclinical systolic and diastolic function abnormalities at subacute follow-up. peak crp during hospitalization may be a useful marker for outpatient cardiac risk stratification. mis-c patients with hypotension icu admission any lvef>< 55% during hospitalization or a peak crp> 18 mg/dL may warrant closer monitoring than those without these risk factors.
