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Updated: May 18, 2026
Assessing Endothelial Vasodilator Function with the Endo-PAT 2000
Published on: October 15, 2010
Long-term evaluation of endothelial function in Kawasaki disease patients
Fátima F Pinto1, Sérgio Laranjo, Filipa Paramés
1Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal.
Insights
Endothelial dysfunction is a common long-term issue in children after Kawasaki disease, even without coronary artery problems. Peripheral arterial tonometry (Endo-PAT) can detect this microvascular dysfunction.
Area of Science:
- Pediatric Cardiology
- Vascular Biology
- Systemic Vasculitis
Background:
- Kawasaki disease is an acute systemic vasculitis with frequent cardiac complications.
- Endothelial dysfunction is a known complication in patients with coronary anomalies.
- Its presence in Kawasaki disease patients without coronary lesions remains under-investigated.
Purpose of the Study:
- To evaluate endothelial dysfunction as a long-term complication in children post-Kawasaki disease.
- To assess the utility of Peripheral Arterial Tonometry (Endo-PAT) in pediatric patients.
- To investigate microvascular function in children with a history of Kawasaki disease and normal coronary arteries.
Main Methods:
- A cohort of Kawasaki disease patients (>5 years post-diagnosis, no coronary lesions) and a control group were assessed.
- Clinical evaluation and Peripheral Arterial Tonometry (Endo-PAT) were performed.
- Reactive Hyperaemia Index (RHI) and Augmentation Index (AI) were measured to assess endothelial function.
Main Results:
- Kawasaki disease patients showed a significantly lower RHI (1.68 ± 0.49) compared to controls (2.31 ± 0.53).
- Augmentation Index was comparable between groups, indicating preserved arterial stiffness.
- A high prevalence of endothelial dysfunction (68%) was observed in Kawasaki disease patients versus 12% in controls.
Conclusions:
- Peripheral Arterial Tonometry (Endo-PAT) is a feasible and reproducible method for assessing endothelial function in children.
- Endothelial dysfunction is a frequent long-term complication in children following Kawasaki disease, even with normal coronary arteries.
- Further validation in larger pediatric populations is warranted.
Background:
Kawasaki disease is an acute systemic vasculitis. Cardiac complications are frequent and include endothelial dysfunction in patients with coronary anomalies. So far, the presence of endothelial dysfunction in patients with no coronary lesions has not been demonstrated. Peripheral arterial tonometry (Endo-PAT) measures the microvascular function in response to local ischaemia and has been validated in adult population, but its use in children is scarce. Aim To evaluate endothelial dysfunction in children as a long-term complication after Kawasaki disease using Endo-PAT.
Methods:
We evaluated two groups of subjects: (1) Kawasaki disease patients over 11 years of age, diagnosed for >5 years, with no coronary lesions, or any other risk factors for cardiovascular disease; (2) control group of individuals without cardiovascular risk factors. Patients and controls were clinically accessed. Endo-PAT was performed to determine reactive hyperaemia index and augmentation index.
Results:
A total of 35 individuals (21 males, age 21 ± 6 years) were evaluated (group 1: 19; controls: 16). Kawasaki disease patients presented significant lower reactive hyperaemia index (1.68 ± 0.49 versus 2.31 ± 0.53; p = 0.001). Augmentation index was similar in both groups (-10 ± 7 versus -11 ± 5; p > 0.005). Most patients with Kawasaki disease disclosed endothelial dysfunction (68%) compared with only 12% in controls.
Conclusions:
Endo-PAT is feasible and reproducible in the child population. Endothelial dysfunction is a frequent long-term complication in patients after Kawasaki disease with normal appearing coronary arteries. However, these results need validation in a larger population.
