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Utilization of Coronary Artery to Aorta for the Early Detection of Kawasaki Disease

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Abstract

Timely diagnosis of coronary involvement is paramount in Kawasaki disease (KD) as it can be associated with long-term morbidity. However, echocardiographic measurements of coronary artery dilation in KD are inconsistent and not proficient for all abnormal arteries. The purpose of this study was to investigate more valuable indices and determine their sensitivity and specificity for early diagnosis of coronary involvement in KD. We performed this retrospective study in 218 children. All patients underwent laboratory and echocardiographic evaluations upon admission. We measured the size of the left main coronary artery (LMA), left anterior descending coronary artery (LAD), right coronary artery (RCA), and aorta (Ao), and calculated the LMA/Ao, LAD/Ao, and RCA/Ao ratios. We also calculated the cut-off values of each index using receiver operating characteristic curves. LMA, LAD, and RCA measurements did not correlate with white blood cell count, platelet count, erythrocyte sedimentation rate, C-reactive protein level, or brain natriuretic peptide level. The LMA measurement was associated with hemoglobin, hematocrit, and iron saturation. LAD/Ao was correlated with white blood cell and platelet counts (P < 0.05), whereas RCA/Ao was correlated with ferritin level (P < 0.05). The cut-off value of LMA/Ao was 0.2, with a sensitivity of 85% and specificity of 70%. Individual coronary artery/Ao ratios might provide helpful insight for detection of coronary abnormality in KD in the acute phase. Further investigation is essential to clarify prompt early diagnosis of coronary involvement in KD.

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Authors and Affiliations

  1. Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea

    Ji-Hoon Na, Sohyun Kim & Lucy Youngmin Eun

  2. Division of Pediatric Cardiology, Department of Pediatrics, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea

    Lucy Youngmin Eun

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  1. Ji-Hoon Na
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  2. Sohyun Kim
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Correspondence to Lucy Youngmin Eun.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the by the institutional review board of Yonsei University College of Medicine and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Na, JH., Kim, S. & Eun, L.Y. Utilization of Coronary Artery to Aorta for the Early Detection of Kawasaki Disease. Pediatr Cardiol 40, 461–467 (2019). https://doi.org/10.1007/s00246-018-1985-6

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  • DOI: https://doi.org/10.1007/s00246-018-1985-6

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