We investigated how the diameter of coronary artery aneurysm (CAA) relates to the distribution immediately after Kawasaki disease (KD). Two hundred and four pts (155 males and 49 females) who had undergone selective coronary angiography (CAGs) less than 100 days after the onset of KD were studied. We measured the maximum diameter of each artery segment in the initial CAGs. We analyzed the relationship between the maximum diameters and the distribution of CAA. We divided the patients into four groups based on the maximum CAA diameter in each patient (large(L) ≥8 mm, medium(M) ≥6 and <8 mm, small(S) ≥4 and <6 mm, very small(VS) <4 mm) and counted the affected segments. There were 87, 61, 36, and 20 patients in groups L, M, S, VS, respectively. The number of segments with CAA in each group was L 6 ± 2, M 4 ± 2, S 2 ± 2, VS 2 ± 1. The number of affected segments in L was significantly more than M, and a large value for L indicated that involvement was significantly more likely to be bilateral. The larger the maximum diameter of CAA, the more extensive disease involvement and the more likely to be bilateral. A large maximum CAA can also indicate coronary involvement in the longitudinal directions. It is an important charcteristic in distribution of CAA caused by KD vasculitis.
Kawasaki disease (KD) Right coronary artery (RCA) Left coronary artery (LCA) Coronary artery aneurysm (CAA) Systemic artery aneurysm (SAA)
This is a preview of subscription content, log in to check access.
We thank Professor Peter Olley and Dr. Setsuko Olley for their consultation of English language. We also thank Koko Asakura for statistic consultation.
This study had no financial support.
Compliance with Ethical Standards
Conflict of interest
The authors state that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Nakamura Y, Yashiro M, Uehara R et al (2012) Epidemiologic features of Kawasaki disease in Japan: results of the 2009–2010 nationwaide survey. J Epidemiol 22:216–221CrossRefPubMedPubMedCentralGoogle Scholar
Fuse S, Kobayashi T, Arakaki Y et al (2010) Standard method for ultrasound imaging of coronary artery in children. Pediatr Int 52:876–882CrossRefPubMedGoogle Scholar
Suzuki A, Takemura A, Inaba R et al (2006) Magnetic resonance coronary angiography to re-evaluate coronary arterial lesions in patients with Kawasaki disease. Cardiol Young 16:563–571CrossRefPubMedGoogle Scholar
Tsujii N, Tsuda E, Kanzaki S et al (2016) Measurements of coronary artery aneurysms due to Kawasaki disease by dual-source computed tomography (DSCT). Pediatr Cardiol 37:442–447CrossRefPubMedGoogle Scholar
Suzuki A, Kamiya T, Kuwahara N et al (1986) Coronary arterial lesions of Kawasaki disease: cardiac catheterization findings of 1100 cases. Pediatr Cardiol 7:3–9CrossRefPubMedGoogle Scholar
JCS Joint Working Group (2014) Guidelines for diagnosis and management of cardiovascular sequelae in Kawasaki disease (JCS 2013) digest version. Circ J 78:2521–2562CrossRefGoogle Scholar
Tsuda E, Kamiya T, Ono Y et al (2005) Incidence of stenotic lesions predicted by acute phase changes in coronary arterial diameter during Kawasaki disease. Pediatr Cardiol 26:73–79CrossRefPubMedGoogle Scholar
Hoshino S, Tsuda E, Yamada O (2015) Characteristics and fate of systemic artery aneurysm caused by Kawasaki disease. J Pediatr 167:108–112CrossRefPubMedGoogle Scholar
Amano S, Hazama F, Hamashima Y (1979) Pathology of Kawasaki disease: I. Pathology and morphogenesis of the vascular changes. Jpn Circ J 43:633–643CrossRefPubMedGoogle Scholar
Naoe S, Takahashi K, Masuda H et al (1991) Kawasaki disease. With particular emphasis on arterial lesions. Acta Pathol Jpn 41:785–797PubMedGoogle Scholar
Takahashi K, Oharaseki T, Yokouchi Y et al (2007) Kawasaki disease arteritis and polyarteritis nodosa. Pathol Case Rev 12: 193–199CrossRefGoogle Scholar
Tsuda E, Hamaoka K, Suzuki H et al (2014) A survey of the 3-decade outcome for patients with giant aneurysms caused by Kawasaki disease. Am Heart J 167:249–258CrossRefPubMedGoogle Scholar
Onouchi Y, Gunji T, Burns JC et al (2008) ITPKC functional polymorphism associated with Kawasaki disease susceptibility and formation of coronary artery aneurysms. Nat Genet 40: 35–42CrossRefPubMedGoogle Scholar
Onouchi Y, Suzuki Y, Suzuki H et al (2013) ITPKC and CASP3 polymorphisms and risks for IVIG unresponsiveness and coronary artery lesion formation in Kawasaki disease. Pharmacogenomics J 13:52–59CrossRefPubMedGoogle Scholar