Skip to main content

Advertisement

SpringerLink
Log in

Changes in Coronary Aneurysm Diameters After Acute Kawasaki Disease from Infancy to Adolescence

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

We clarified the changes in coronary artery diameters based on the degree of coronary artery involvement immediately after acute Kawasaki disease (KD). Two hundred sixteen coronary arteries in 85 patients after KD examined by two-dimensional echocardiography were reviewed from 1995. The maximal internal diameters were measured at 2 months, 1 year, 3 years, 10 years and 15 years after KD. The coronary arteries were divided into five groups based on the absolute diameter at 2 months, as well as six groups based on the Z score at 2 months. The maximum diameters were compared at 2 months with those during follow-up in each group. The numbers of right coronary, left anterior descending, left coronary, and left circumflex arteries were 84, 73, 55 and 4, respectively. There was a significant relationship between the maximum internal diameter at 2 months and subsequent changes in the maximum diameters after KD in the late period in both groups (p < 0.0001). The maximum diameters of coronary artery aneurysms (CAAs) ≥ 8.0 mm at 2 months did not change significantly after 1 year, however, the maximum diameter of CAAs < 8.0 mm was significantly smaller in the late period (p < 0.05). Coronary arteries without dilatation at 2 months after KD grew normally. CAAs with a maximum diameter ≥ 6.0 mm and Z score ≥ 7.5 at 2 months after KD persisted in adolescents, whereas coronary arteries with diameters < 6.0 mm and Z score < 7.5 could be within normal ranges in the late period.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Tsuda E, Tsujii N, Kimura K, Suzuki A (2017) Distribution of Kawasaki disease coronary artery aneurysms and the relationship to coronary artery diameter. Pediatr Cardiol 38:932–940

    Article  Google Scholar 

  2. McCrindle BW, Js Li, Minich LL et al (2007) Coronary artery involvement in children with Kawasaki disease. risk factors from analysis of serial normalized measurements. Circulation 116:174–179

    Article  Google Scholar 

  3. Friedman KG, Gauvreau K, Okamoto-Hamaoka A et al (2016) Coronary artery aneurysms in Kawasaki disease: risk factors for progressive disease and adverse cardiac events in the US population. JAHA 5:e003289. https://doi.org/10.1161/JAHA.116.003289

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Tsuda E, Kamiya T, Ono Y, Kimura K, Kurosaki K, Echido S (2005) Incidence of stenotic lesions predicted by acute phase changes in coronary arterial diameter during Kawasaki disease. Pediatr Cardiol 26:73–79

    Article  CAS  Google Scholar 

  5. Tamaki W, Tsuda E, Igarashi T, Tanaka N, Fujieda M (2015) Importance of evaluation of the right coronary artery by two-dimensional echocardiography in patients after Kawasaki disease: a right parasite approach. Heart Vessels 30:178–185

    Article  Google Scholar 

  6. Tsuda E, Tsujii N, Hayama Y (2018) Stenotic lesions and the maximum diameter of coronary artery aneurysms in Kawasaki disease. J Pediatr 194:165–170

    Article  Google Scholar 

  7. Fuse S, Kobayashi T, Arakaki Y et al (2010) Standard method for ultrasound imaging of coronary artery in children. Pediatr Int 52:876–882

    Article  Google Scholar 

  8. Guidelines for diagnosis and management of cardiovascular sequelae in Kawasaki disease (JCS) (2013) Digest version. Circ J 2014(78):2521–2562

    Google Scholar 

  9. Tsuda E, Kamiya T, Kimura K, Ono Y, Echigo S (2002) Coronary artery dilatation exceeding 4.0mm during acute Kawasaki disease predicts a high probability of subsequent late intima-medial thickening. Pediatr Cardiol 23:9–14

    Article  CAS  Google Scholar 

  10. Dionne A, Ibrahim R, Gebhard C et al (2018) Difference between persistent aneurysm, regressed aneurysm and coronary dilation in Kawasaki disease: an optical coherence tomography study. Can J Cardiol 34:1120–1128

    Article  Google Scholar 

  11. Kawai H, Takakuwa Y, Naruse H et al (2015) Two cases with past Kawasaki disease developing acute myocardial infarction in the thirties, despite being regarded as at low risk for coronary events. Heart Vessls 30:549–553

    Article  Google Scholar 

  12. Mitani Y, Tsuda E, Kato H et al (2019) Emergence and characterization of acute coronary syndrome in adults after confirmed or missed history of Kawasaki disease in Japan: a Japanese nationwide survey table 1. Front Pediatr. https://doi.org/10.3389/fped.2019.00275

    Article  PubMed  PubMed Central  Google Scholar 

  13. Tsuda E, Yoneda S, Asaumi Y, Suzuki A (2020) Cardiac events in patients in their forties with regression of coronary artery aneurysms after Kawasaki disease. Cardiol young 30:1821–1825

    Article  Google Scholar 

  14. Tsujii N, Tsuda E, Kanzaki S, Ishiduka J, Nakashima K, Kurosaki K (2017) Late wall thickening and calcification after Kawasaki disease. J Pediatr 181:167–171

    Article  Google Scholar 

Download references

Acknowledgements

We thank Mr. John Martin for his kind English language consultation.

Funding

This study had no financial support.

Author information

Authors and Affiliations

  1. Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka, Japan

    Etsuko Tsuda

  2. Department of Physiological Laboratory, National Cerebral and Cardiovascular Center, Suita, Japan

    Shuji Hashimoto

Authors
  1. Etsuko Tsuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shuji Hashimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Etsuko Tsuda.

Ethics declarations

Conflict of interest

The authors state that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participates were in accordance with the institutional committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Bland-Altman plot to show the intra-observer agreement for the diameters of the CAAs by 2DE

Supplementary file1 (JPG 42 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tsuda, E., Hashimoto, S. Changes in Coronary Aneurysm Diameters After Acute Kawasaki Disease from Infancy to Adolescence. Pediatr Cardiol 42, 1749–1756 (2021). https://doi.org/10.1007/s00246-021-02659-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-021-02659-1

Keywords

Search

Navigation