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Hemodynamic factors of thrombus formation in coronary aneurysms associated with Kawasaki disease

Y Kuramochi1, T Ohkubo, N Takechi

  • 1Department of Pediatrics, Nippon Medical School, Tokyo, Japan. rio-ma7@nms.ac.jp

Pediatrics International : Official Journal of the Japan Pediatric Society
|November 4, 2000
PubMed

Insights

Thrombus formation in coronary aneurysms is linked to reduced blood flow velocity and shear stress, particularly in larger aneurysms. These rheological changes in Kawasaki disease patients may initiate clot development.

Area of Science:

  • Cardiovascular Research
  • Rheology
  • Pediatric Cardiology

Background:

  • Investigating the mechanisms of thrombus formation in coronary aneurysms.
  • Utilizing rheological findings to understand clot development.
  • Focusing on patients with Kawasaki disease.

Purpose of the Study:

  • To elucidate the relationship between coronary aneurysm size and hemodynamic parameters.
  • To identify rheological factors contributing to thrombus formation in coronary aneurysms.

Main Methods:

  • Studied 43 coronary aneurysms in 33 pediatric patients with Kawasaki disease.
  • Categorized aneurysms into small, medium, and large groups based on diameter.
  • Measured coronary flow velocity and perfusion pressure using Doppler and pressure-monitoring guidewires.
  • Calculated average peak velocity (APV) index, mean coronary perfusion pressure (P) index, and shear index.

Main Results:

  • A significant decrease in APV index and shear index was observed with increasing aneurysm size (p < 0.005).
  • APV index values were 0.893, 0.573, and 0.128 for small, medium, and large aneurysms, respectively.
  • Shear index values were 0.750, 0.328, and 0.020 for small, medium, and large aneurysms, respectively.
  • Coronary perfusion pressure did not correlate with aneurysm size and showed no significant difference compared to normal vessels.

Conclusions:

  • Reduced blood flow velocity (stagnation) and decreased shear stress within coronary aneurysms are implicated in initiating thrombus formation.
  • These findings highlight the role of rheology in the pathophysiology of coronary aneurysms and associated thrombosis.
Abstract

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