European Journal of Pediatrics

, Volume 167, Issue 2, pp 189–196

Endothelial dysfunction in adult patients with a history of Kawasaki disease

  • Ayumi Niboshi
  • Kenji Hamaoka
  • Koichi Sakata
  • Nozomi Yamaguchi
Original Paper

DOI: 10.1007/s00431-007-0452-9

Cite this article as:
Niboshi, A., Hamaoka, K., Sakata, K. et al. Eur J Pediatr (2008) 167: 189. doi:10.1007/s00431-007-0452-9

Abstract

To assess the existence of endothelial dysfunction and the possibility of the early onset of atherosclerosis in the chronic stage of Kawasaki disease (KD), we examined endothelial function in adult patients late after the onset of KD. We evaluated two age-matched groups: 35 adult KD patients (KD group) (mean age, 27.0 years; mean interval time, 24.1 years), and 36 healthy adults (control group). To assess vascular endothelial function, flow-mediated dilatation (%FMD) of the brachial artery and urinary nitrites and nitrates (NOx) were examined. We also measured adhesion molecules and several coagulation-fibrinolysis markers. In addition, we measured high-sensitive C-reactive protein (hs-CRP) as a chronic inflammatory marker, and brachial-ankle pulse wave velocity (baPWV) as a marker for arterial stiffness. %FMD was significantly reduced in the KD group when compared with that of the control group (KD group, 10.4 ± 2.6%; control group, 14.4 ± 3.2%, p<0.05), particularly in patients with coronary artery lesions. Thrombin-antithrombin III complex values were higher in the KD group, although no significant differences were observed in the other markers for endothelial function. Hs-CRP was significantly elevated only in the patients with coronary aneurysms. Furthermore, in the male KD patients, the baPWV values were significantly higher than those in the control subjects. This study revealed that the adult patients with a history of KD had systemic vascular endothelial dysfunction, and also suggested that a history of KD was possibly one of the risk factors for early onset of atherosclerosis.

Keywords

Kawasaki diseaseAdultVascular endothelial functionHigh-sensitive C-reactive proteinAtherosclerosis

Abbreviations

KD

kawasaki disease

CALs

coronary artery lesions

%FMD

Flow-mediated dilatation

ISDN

Isosorbide dinitrite

%EID

Endothelium-independent dilatation

SBP

systemic blood pressure

DBP

diastolic blood pressure

Cre

Creatinine

NOx

Nitrites and nitrates

sICAM-1

Soluble intercellular adhesion molecule-1

sVCAM-1

Soluble vascular adhesion molecule-1

TAT

Thrombin-antithrombin III complex

tPA PAI-1

Tissue plasminogen activator-plasminogen activator inhibitor-1 complex

vWV

Von Willebrand factor

hs-CRP

high-sensitive C-reactive protein

BMI

body mass index

TC

total cholesterol

HDL-C

High-density lipoprotein cholesterol

LDL-C

Low-density lipoprotein cholesterol

TG

Triglyceride

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Ayumi Niboshi
    • 1
    • 3
  • Kenji Hamaoka
    • 1
  • Koichi Sakata
    • 1
  • Nozomi Yamaguchi
    • 2
  1. 1.Department of Pediatric Cardiology and NephrologyKyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan
  2. 2.Department of Environmental Systems ScienceFaculty of Engineering, Doshisha UniversityKyotoJapan
  3. 3.Kamigyo-ku, KyotoJapan