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Evaluation of Preclinical Atherosclerosis by Flow-Mediated Dilatation of the Brachial Artery and Carotid Artery Analysis in Patients with a History of Kawasaki Disease

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Abstract

Cardiac sequelae of Kawasaki disease are an important cause of ischemic heart disease in young adults. The possibility of early progression of atherosclerosis following Kawasaki disease is therefore of great concern. We examined whether preclinical atherosclerotic changes are seen in patients with a history of Kawasaki disease, and whether these changes appear in all or in only a proportion of patients. Sixty-five patients with a history of Kawasaki disease, aged 13.1 ± 2.1 years, and 20 aged-matched controls participated in the study. All subjects underwent flow-mediated dilatation (FMD) of the brachial artery and analysis of carotid artery size and pulse-wave transmission. Patients were classified into four groups depending on the severity of the maximum coronary artery lesion: group 0 (normal), group 1 (mild), group 2 (moderate), and group 3 (severe). There was no statistical difference in the carotid artery analyses between the four groups. FMD (mean ± SD) was significantly lower in groups 2 and 3 than in groups 0 and 1 and the control group (group 0, 19.4 ± 3.9%; group 1, 19.5 ±4.1%; group 2, 8.9 ± 2.8%; group 3, 4.2 ± 1.5%; control group, 18.8 ± 2.8%; p < 0.0001). There was a significantly negative correlation between the severity of the coronary artery lesion and FMD (p < 0.0001 for both). Endothelial dysfunction was revealed by FMD in patients with persistent coronary artery lesions subsequent to Kawasaki disease. Preclinical atherosclerosis may be present only in patients with coronary aneurysms.

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References

  1. Anderson TJ, Uehata A, Gerhard MD, et al. (1950) Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol 26:1235–1241

    Google Scholar 

  2. Celermajer DS, (1998) Testing endothelial function using ultrasound. J Cardiovasc Pharmacol 32(suppl 3):S29–S32

    PubMed  Google Scholar 

  3. Celermajer DS, Sorensen KE, Gooch VM, et al. (1992) Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 340:1111–1115

    Article  CAS  PubMed  Google Scholar 

  4. Corretti MC, Anderson TJ, Benjamin EJ, et al. (2002) Guidelines for the ultrasound assessment of endothelial-dependent flow mediated vasodilation of the brachial artery. J Am 39:257–265

    PubMed  Google Scholar 

  5. Corretti MC, Plotnick GD, Vogel RA (1995) Technical aspects of evaluating brachial artery vasodilation using high-frequency ultrasound. Am J Physiol 268:H1397–H1404

    CAS  PubMed  Google Scholar 

  6. Dhillon R, Clarkson P, Donald AE, et al. (1996) Endothelial dysfunction late after Kawasaki disease. Circulation. 94:2103–2106

    CAS  PubMed  Google Scholar 

  7. Doshi SN, Naka KM, Payne N, et al. (2001) Flow-mediated dilation following wrist and upper arm occlusion in humans: the contribution of nitric oxide. Clin Sci 101:629–635

    CAS  PubMed  Google Scholar 

  8. Guyton JR (1998) Lipoprotein metabolism and atherosclerosis: Genetics and pathophysiology. In: Garson A, Bricker JT (eds) The Science and Practice of Pediatric Cardiology, 2nd edn. Waverly, Williams & Wilkins, Baltimore, pp 491–509

    Google Scholar 

  9. lemura M, Ishii M, SugimuraT, Akagi T, Kato H (2000) Long term consequences of regressed aneurysms after Kawasaki disease: vascular wall morphology and function. Heart 83:307–311

    Google Scholar 

  10. Japan Kawasaki Disease Research Committee (1984) Diagnostic Guideline of Kawasaki Disease, 4th rev edn. Kawasaki Disease Research Committee, Tokyo

    Google Scholar 

  11. Jäyisalo JM, Jartti L, Salonen KN, et al. (2001) Increased aortic intima-media thickness. Circulation 104:2943–2947

    PubMed  Google Scholar 

  12. Kuvin JT, Patel AR, Sliney KA, et al. (2001) Peripheral vascular endothelial function testing as a noninvasive indicator of coronary artery disease. J Am Coll Cardiol 38:1843–1849

    Article  CAS  PubMed  Google Scholar 

  13. Libby P, Ridker PM, Maseri A (2002) Inflammation and atherosclerosis. Circulation 105:1135–1143

    CAS  PubMed  Google Scholar 

  14. Nakano H, Ueda K, Saito A, Nojima K (1985) Repeated quantitative angiograms in coronary arterial aneurysm in Kawasaki disease. Am J Cardiol 56:846–851

    CAS  PubMed  Google Scholar 

  15. Neunteufl T, Katzenschlager R, Hassen A, et al. (1997) Systemic endothelial dysfunction is related to the extent and severity of coronary artery disease. Atherosclerosis 129:111–118

    Article  CAS  PubMed  Google Scholar 

  16. Newburger JW, Takahashi M, Gerber MA, et al. (2004) Diagnosis, treatment, and long-term management of Kawasaki disease. Circulation 110:2747–2771

    Article  PubMed  Google Scholar 

  17. Noto N, Okada T, Yamasuge M, et al. (2001) Noninvasive assessment of the early progression of atherosclerosis in adolescents with Kawasaki disease and coronary artery lesions. Pediatrics 107:1095–1099

    Article  CAS  PubMed  Google Scholar 

  18. Popele NM, Grobbee DE, Bots ML, et al. (2001) Association between arterial stiffness and atherosclerosis: The Rotterdam study. Stroke 32:454–460

    PubMed  Google Scholar 

  19. Ross R (1993) The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature 362:801–809

    Article  CAS  PubMed  Google Scholar 

  20. Ross R (1999) Atherosclerosis—an inflammatory disease. N Engl J Med 340:115–126

    Article  CAS  PubMed  Google Scholar 

  21. Salonen JT, Salonen R (1993) Ultrasound B-mode imaging in observational studies of atherosclerotic progression. Circulation 87(Suppl II):II-56–II-65

    CAS  PubMed  Google Scholar 

  22. Schroeder S, Enderle MD, Ossen R, et al. (1999) Noninvasive determination of endothelium-mediated vasodilation as a screening test for coronary artery disease: Pilot study to assess the predictive value in comparison with angina pectoris, exercise electrocardiography, and myocardial perfusion imaging. Am Heart J 138:731–739

    Article  CAS  PubMed  Google Scholar 

  23. Silva AAE, Maeno Y, Hashimi A, et al. (2001) Cardiovascular risk factors after Kawasaki disease: a case–control study. J Pediatr 138:400–405

    CAS  PubMed  Google Scholar 

  24. Sugimura T, Kato H, Inoue O, et al. (1992) Vasodilatory response of the coronary arteries after Kawasaki disease: evaluation by intracoronary injection of isosorbide dinitrate, J Pediatr 121:684–688

    CAS  PubMed  Google Scholar 

  25. Suzuki A, Kamiya T, Arakaki Y, Kinoshita Y, Kimuara K (1994) Fate of coronary arterial aneurysms in Kawasaki disease. 74:822–824

    Article  CAS  PubMed  Google Scholar 

  26. Suzuki A, Yamagishi M, Kimura K, et al. (1996) Functional behavior and morphology of the coronary artery wall in patients with Kawasaki disease assessed by intravascular ultrasound. J Am Coll Cardiol 27:291–298

    CAS  PubMed  Google Scholar 

  27. Takahashi M (2001) Kawasaki syndromaln. In: Alien HD, Clark EB (eds) Moss and Adams’ Heart Disease in Infants, Children, and adolescents 6th edn. Lippincott Williams & Wilkins, Baltimore, 1216–1225

    Google Scholar 

  28. Teragawa H, Kato M, Kurokawa J, et al. (2001) Usefulness of flow-mediated dilation of the brachial artery and/or the intima-media thickness of the carotid artery in predicting coronary narrowing in patients suspected of having coronary artery disease. Am J Cardiol 88:1147–1151

    Article  CAS  PubMed  Google Scholar 

  29. Urabe T, Morikawa N (1995) Differentiation of embolic and thrombotic middle cerebral artery occlusion using ultrasonic carotid flow velocity analysis. J Neurol 128:181–187

    Article  CAS  PubMed  Google Scholar 

  30. Velican D, Velican C (1979) Study of fibrous plaques occurring in the coronary arteries of children. Atherosclerosis 33:201–215

    CAS  PubMed  Google Scholar 

  31. Vita JA, Loscalzo JL (2002) Shouldering the risk factor burden. Circulation 106:164–166

    PubMed  Google Scholar 

  32. Watts K, Beye P, Siafarikas A, et al. (2004) Effects of exercise training on vascular function in obese children. J Pediatr 144:620–625

    PubMed  Google Scholar 

  33. Yamakawa R, Ishii M, Sugimura T et al. (1998) Coronary endothelial dysfunction after Kawasaki disease: evaluation by intracoronary injection of acethylcholine. J Am Coll Cardiol 31:1074–1080

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This study was supported by the Mami Mizutani Foundation and the Morinaga Hoshikai.

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Authors and Affiliations

  1. Department of Pediatrics, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka, 570-8506, Japan

    Y. Ikemoto, H. Ogino, M. Teraguchi & Y. Kobayashi

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  1. Y. Ikemoto
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  2. H. Ogino
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  3. M. Teraguchi
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  4. Y. Kobayashi
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Correspondence to Y. Ikemoto.

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Ikemoto, Y., Ogino, H., Teraguchi, M. et al. Evaluation of Preclinical Atherosclerosis by Flow-Mediated Dilatation of the Brachial Artery and Carotid Artery Analysis in Patients with a History of Kawasaki Disease. Pediatr Cardiol 26, 782–786 (2005). https://doi.org/10.1007/s00246-005-0921-8

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  • DOI: https://doi.org/10.1007/s00246-005-0921-8

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