Vascular Health in Kawasaki Disease JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY Tierney, E. S., Gal, D., Gauvreau, K., Baker, A. L., Trevey, S., O'Neill, S. R., Jaff, M. R., de Ferranti, S., Fulton, D. R., Colan, S. D., Newburger, J. W. 2013; 62 (12): 1114-1121

Abstract

Our objective was to compare the indices of vascular health in KD patients to those of control subjects.Background: Literature on peripheral vascular health after Kawasaki disease (KD) is conflicting.Subjects were patients 11-29 years with KD onset >12 months prior to study visit (n=203) and healthy control subjects (n=50). We measured endothelial function (EndoPAT-Index), intima-media thickness (IMT) of right and left common carotid arteries (RCCA and LCCA), and fasting lipid-profile and C-reactive protein (CRP). KD patients were classified according to their worst-ever coronary artery (CA) status: Group I-always normal CAs (n=136, 67%); Group II-CA z-scores = 2 but <3 (n=20, 10%); Group III-CA aneurysm z-scores = 3 but <8mm (n=40, 20%), and Group IV-giant CA aneurysm, defined as = 8mm (n=7, 3%).At a median of 11.6y (1.2 - 26 years) after KD onset, compared to controls, KD patients had a higher peak velocity in the LCCA (p=0.04) and higher pulsatility index of both RCCA and LCCA (p=0.006 and p=0.05, respectively). However, there were no differences in the EndoPAT index, carotid IMT or stiffness. Mean IMT of LCCA tended to differ across the KD subgroups and control group (p=0.05), with a higher mean in Group IV. Otherwise the KD subgroups and control group had similar vascular health indices.In contrast to some earlier reports, our study in North American children and young adults demonstrated that KD patients whose maximum CA dimensions were either always normal or mildly ectatic have normal vascular health indices, providing reassurance regarding peripheral vascular health in this population.

View details for DOI 10.1016/j.jacc.2013.04.090

View details for Web of Science ID 000324047800014

View details for PubMedID 23835006