Korean Circ J.  2009 Jul;39(7):264-269. 10.4070/kcj.2009.39.7.264.

Carotid Intima-Media Thickness and Pulse Wave Velocity After Recovery From Kawasaki Disease

Affiliations
  • 1Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea. hongym@chollian.net
  • 2Department of Radiology, Ewha Womans University School of Medicine, Seoul, Korea.

Abstract

BACKGROUND AND OBJECTIVES
Kawasaki disease (KD) is an acute inflammatory process affecting the arterial walls that results in panvasculitis. Recent studies have shown that even after resolution of the disease, endothelial dysfunction persists and may progress to atherosclerosis. The pulse wave velocity (PWV) and the ankle-brachial index (ABI) are simple and non-invasive methods for evaluating the degree of atherosclerosis, and are known as the predictors of cardiovascular disease in adults. Carotid intima-media thickness (cIMT) is also known as a predictor of cardiovascular disease. We conducted this study to determine the change in arterial stiffness by measuring the PWV, ABI, and cIMT in children who have recovered from KD. SUBJECTS AND METHODS: Twenty-five patients with KD and coronary aneurysm were recruited. They all recovered from KD and were normal for more than 8 years. Fifty-five healthy children were evaluated as the control group. Their height, weight, body mass index, and blood pressure (systolic, diastolic, and the mean) were measured. The PWV, ABI, ejection time (ET), and pre-ejection period (PEP) were measured by ultrasonography. The cIMT was measured by ultrasonography. RESULTS: The left brachial ankle PWV was significantly higher in the KD group (1020.6+/-146.5 cm/sec) than the control group (984.0+/-96.5 cm/sec). The ABI did not differ between the two groups. There was no difference in PEP/ET and cIMT. CONCLUSION: The PWV in children who recovered from KD was higher than the control group. Long-term follow up is necessary in children after recovery from KD even if there is no abnormality in echocardiography.

Keyword

Kawasaki disease; Arterial stiffness; Ankle-brachial index; Carotid arteries

MeSH Terms

Adult
Animals
Ankle
Ankle Brachial Index
Atherosclerosis
Blood Pressure
Body Weight
Cardiovascular Diseases
Carotid Arteries
Carotid Intima-Media Thickness
Child
Coronary Aneurysm
Echocardiography
Humans
Mucocutaneous Lymph Node Syndrome
Pulse Wave Analysis
Vascular Stiffness

Reference

1. Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Arerugi. 1967. 16:178–222.
2. Burns JC, Glode MP. Kawasaki syndrome. Lancet. 2004. 364:533–544.
3. Park YW, Han JW, Park IS, et al. Kawasaki disease in Korea, 2003-2005. Pediatr Infect Dis J. 2007. 26:821–823.
4. Burns JC, Shike H, Gordon JB, Malhotra A, Schoenwetter M, Kawasaki T. Sequelae of Kawasaki disease in adolescents and young adults. J Am Coll Cardiol. 1996. 28:253–257.
5. Kato H, Ichinose E, Yoshioko F, et al. Fate of coronary aneurysms in Kawasaki disease: serial coronary angiography and long-term follow-up study. Am J Cardiol. 1982. 49:1758–1766.
6. Dhillon R, Clarkson P, Conald A, et al. Endothelial dysfunction late after Kawasaki disease. Circulation. 1996. 94:2103–2106.
7. Lee YS, Kim KS, Nam CW, et al. Clinical implication of carotidradial pulse wave velocity for patients with coronary artery disease. Korean Circ J. 2006. 36:565–572.
8. Han SH, Park CG, Park SW, et al. High aortic stiffness assessed by pulse wave velocity is an independent predictor of coronary artery calcification and stenosis in suspected coronary artery disease patients. Korean Circ J. 2004. 34:468–476.
9. Jeong IB, Bae JH, Kim KY, et al. The carotid intima-media thickness as a screening test for coronary artery disease. Korean Circ J. 2005. 35:460–466.
10. Tounian P, Aggoun Y, Dobem B, et al. Presence of increased stiffness of the commom carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet. 2001. 358:1400–1404.
11. Pauciullo P, Iannuzzi A, Sartorio R, et al. Increased intima-media thickness of the common carotid artery in hypercholesterolemic children. Arterioscler Thromb. 1994. 14:1075–1079.
12. Jarvisalo MJ, Putto-Laurila A, Jartti L, et al. Carotid artery intima-media thickness in children with type I diabetes. Diabetes. 2002. 51:493–498.
13. Cheung YF, Wong SJ, Ho MH. Relationship between carotid intima media thickness and arterial stiffness in children after Kawasaki disease. Arch Dis Child. 2007. 92:43–47.
14. Nato N, Okada T, Yamasuge M, et al. Noninvasive assessment of the early progression of atherosclerosis in adolescents with Kawasaki disease and coronary artery lesions. Pediatrics. 2001. 107:1095–1099.
15. Ikemoto Y, Ogino H, Teraguchi M, Kobayashi Y. Evaluation of preclinical atherosclerosis by flow-mediated dilatation of the brachial artery and carotid artery analysis in patient with a history of Kawasaki disease. Pediatr Cardiol. 2005. 26:782–786.
16. Kato H, Koike S, Yamamoto M, Ito Y, Yano E. Coronary aneurysms in infants and young children with acute febrile mucocutaneous lymph node syndrome. J Pediatr. 1975. 86:892–898.
17. Takahashi M, Mason W, Lewis AB. Regression of coronary aneurysms in patients with Kawasaki syndrome. Circulation. 1987. 75:387–394.
18. Niboshi A, Hamaoka K, Sakata K, Yamaguchi N. Endothelial dysfunction in adult patients with a history of Kawasaki disease. Eur J Pediatr. 2008. 167:189–196.
19. Takahashi K, Oharaseki T, Naoe OS. Pathological study of post-coronary arteritis in adolescents and young adults: with reference to the relationship between sequelae of Kawasaki disease and atherosclerisos. Pediatr Cardiol. 2001. 22:138–142.
20. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002. 105:1135–1143.
21. Ross R. The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature. 1993. 362:801–809.
22. Ross R. Atherosclerosis: an inflammatory disease. N Engl J Med. 1999. 340:115–126.
23. Senzaki H, Chen CH, Ishido H, et al. Arterial haemodynamics in patients after Kawasaki disease. Circulation. 2005. 111:2119–2125.
24. Ooyanagi R, Fuse S, Tomita H, et al. Pulse wave velocity and ankle brachial index in patients with Kawasaki disease. Pediatr Int. 2004. 46:398–402.
25. Nato N, Okada T, Yamasuge M, et al. Noninvasive assessment of the early progression of atherosclerosis in adolescents with Kawasaki disease and coronary artery lesions. Pediatrics. 2001. 107:1095–1099.
26. Cheung YF, Yung TC, Tam SC, Ho MH, Chau AK. Novel and traditional cardiovascular risk factors in children after Kawasaki disease. J Am Coll Cardiol. 2004. 43:120–124.
27. Suzuki A, Yamagishi M, Kimura K, et al. Functional behavior and morphology of the coronary artery wall in patients with Kawasaki disease assessed by intravascular ultrasound. J Am Coll Cardiol. 1996. 27:291–296.
28. Amano S, Hazama F, Hamashima Y. Pathology of Kawasaki disease: I. pathology and morphogenesis of the vascular changes. Jpn Cir J. 1979. 43:633–643.
29. Newburger JW, Takahashi M, Gerber MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic fever, endocarditis, and Kawasaki disease, Council on cardiovascular diseases in the young. Pediatrics. 2004. 114:1708–1733.
30. Furuyama H, Odagawa Y, Katoh C, et al. Altered myocardial flow reserve and endocardial function late after Kawasaki disease. J Pediatr. 2003. 142:149–154.
31. Saliva AA, Maeno Y, Hashimi A, Smallborn JF, Siverman ED, McCrindle BW. Cardiovascular risk factors after Kawasaki disease: a case-control study. J Pediatr. 2001. 138:400–405.
32. Iemura M, Ishii M, Sugimura T, Akagi T, Kato H. Long term consequences of regressed coronary aneurysm after Kawasaki disease: vascular wall morphology and function. Heart. 2000. 83:307–311.
Full Text Links
  • KCJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr