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Ascending Aorta Elastography After Kawasaki Disease Compared to Systemic Hypertension

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Abstract

Kawasaki disease (KD) is a systemic vasculitis, classically affecting large- and medium-size arteries. The coronary arteries draw most of the clinical attention, whereas few studies have taken interest in the ascending aorta. Using a proprietary imaging-based mechanical biomarker (ImBioMark), we sought to determine aortic stiffness in KD compared to systemic hypertension (HTN) and healthy children. We evaluated parasternal long-axis views focused on the ascending aorta in 20 controls, 12 KD, and 8 HTN as a comparative clinical model of vascular stiffness. We calculated systolic and diastolic aortic wall strain with ImBioMark. Strain was tested for normality against height, systolic, and diastolic blood pressure in normal subjects. Strain from KD and HTN was normalized (Z score) accordingly. Z score comparisons were performed using nonparametric statistics. Age was similar between KD and HTN (9.1 ± 5.3 and 9.9 ± 5.3 years old; p = NS). Systolic and diastolic strain values were normally distributed against height, systolic blood pressure, and diastolic blood pressure in healthy subjects. HTN subjects had abnormal systolic and diastolic strain values (p < 0.0001). Whereas KD subjects had normal diastolic strain, systolic strain was significantly lower (p < 0.001), and systolic strain was intermediate between controls and HTN. There were no significant differences in aortic strain among KD, however, according to the presence of coronary artery aneurysms. Despite normal blood pressure, the ascending aorta in KD exhibits reduced strain during systole. This may reflect in situ rigidity of the aorta. The normal diastolic strain in KD may, in contrast, reflect normal peripheral vascular resistance.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical standard

This work was completed according to local and international ethics standards for human research. It was granted institutional ethics approval complying with regulations granting proper respect of human rights. Informed consent was waved by institutional board according to applicable laws on retrospective data.

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Authors and Affiliations

  1. Division of Pediatric Cardiology (6, Bloc 9), CHU Sainte-Justine, University of Montreal, 3175 Côte Ste-Catherine, Montreal, QC, H3T 1C5, Canada

    Ian Nandlall, Anne Fournier & Nagib Dahdah

  2. Department of Family Medicine, McGill University, Montreal, QC, Canada

    Ian Nandlall

  3. CHU Ste-Justine Research Center, Montreal, QC, Canada

    Roch L. Maurice & Nagib Dahdah

  4. Division of Pediatric Nephrology, CHU Ste-Justine, Montreal, QC, Canada

    Aïcha Merouani

Authors
  1. Ian Nandlall
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  2. Roch L. Maurice
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  3. Anne Fournier
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  4. Aïcha Merouani
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  5. Nagib Dahdah
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Correspondence to Nagib Dahdah.

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Nandlall, I., Maurice, R.L., Fournier, A. et al. Ascending Aorta Elastography After Kawasaki Disease Compared to Systemic Hypertension. Pediatr Cardiol 36, 1417–1422 (2015). https://doi.org/10.1007/s00246-015-1175-8

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  • DOI: https://doi.org/10.1007/s00246-015-1175-8

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