Carotid intima-media thickness and pulse wave velocity after recovery from kawasaki disease
Soo Jin Lee1, Hye Mi Ahn, Jung Hyun You
1Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea.
Insights
Children who recovered from Kawasaki disease (KD) show increased arterial stiffness, indicated by higher pulse wave velocity (PWV). Long-term monitoring is crucial for these patients, even with normal echocardiograms, to assess cardiovascular risk.
Area of Science:
- Pediatric Cardiology
- Vascular Biology
- Rheumatology
Background:
- Kawasaki disease (KD) is an acute inflammatory condition affecting arteries, potentially leading to persistent endothelial dysfunction and atherosclerosis.
- Pulse wave velocity (PWV), ankle-brachial index (ABI), and carotid intima-media thickness (cIMT) are established markers for assessing arterial stiffness and cardiovascular disease risk.
Purpose of the Study:
- To evaluate changes in arterial stiffness in children who have recovered from Kawasaki disease.
- To assess arterial stiffness using PWV, ABI, and cIMT measurements in a cohort of pediatric KD survivors.
Main Methods:
- Twenty-five children with a history of KD and coronary aneurysms, recovered for over 8 years, were compared to 55 healthy controls.
- Measurements included anthropometrics, blood pressure, pulse wave velocity (PWV), ankle-brachial index (ABI), ejection time (ET), pre-ejection period (PEP), and carotid intima-media thickness (cIMT) via ultrasonography.
Main Results:
- Left brachial-ankle PWV was significantly higher in the KD recovery group compared to controls (1020.6±146.5 cm/sec vs. 984.0±96.5 cm/sec).
- No significant differences were observed in ABI, PEP/ET, or cIMT between the KD and control groups.
Conclusions:
- Children who have recovered from Kawasaki disease exhibit increased arterial stiffness, as evidenced by elevated PWV.
- Continued long-term follow-up is recommended for children post-KD, irrespective of echocardiographic findings, to monitor potential cardiovascular sequelae.
Background And Objectives:
Kawasaki disease (KD) is an acute inflammatory process affecting the arterial walls that results in panvasculitis. Recent studies have shown that even after resolution of the disease, endothelial dysfunction persists and may progress to atherosclerosis. The pulse wave velocity (PWV) and the ankle-brachial index (ABI) are simple and non-invasive methods for evaluating the degree of atherosclerosis, and are known as the predictors of cardiovascular disease in adults. Carotid intima-media thickness (cIMT) is also known as a predictor of cardiovascular disease. We conducted this study to determine the change in arterial stiffness by measuring the PWV, ABI, and cIMT in children who have recovered from KD.
Subjects And Methods:
Twenty-five patients with KD and coronary aneurysm were recruited. They all recovered from KD and were normal for more than 8 years. Fifty-five healthy children were evaluated as the control group. Their height, weight, body mass index, and blood pressure (systolic, diastolic, and the mean) were measured. The PWV, ABI, ejection time (ET), and pre-ejection period (PEP) were measured by ultrasonography. The cIMT was measured by ultrasonography.
Results:
The left brachial ankle PWV was significantly higher in the KD group (1020.6+/-146.5 cm/sec) than the control group (984.0+/-96.5 cm/sec). The ABI did not differ between the two groups. There was no difference in PEP/ET and cIMT.
Conclusion:
The PWV in children who recovered from KD was higher than the control group. Long-term follow up is necessary in children after recovery from KD even if there is no abnormality in echocardiography.
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