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Endothelial dysfunction in children within 5 years after onset of Kawasaki disease

Takamichi Ishikawa1, Satoru Iwashima

  • 1Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan.

The Journal of Pediatrics
|June 14, 2013
PubMed

Insights

Children with Kawasaki disease (KD) show arterial endothelial dysfunction within five years of illness onset. Longer fever duration correlates with increased inflammation-induced endothelial dysfunction, highlighting the importance of early intervention.

Area of Science:

  • Pediatric Cardiology
  • Vascular Biology
  • Immunology

Background:

  • Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
  • Endothelial dysfunction is an early indicator of cardiovascular risk.
  • Long-term effects of KD on vascular health require further investigation.

Purpose of the Study:

  • To assess endothelial function in children diagnosed with Kawasaki disease (KD) up to five years post-illness onset.
  • To compare endothelial function between KD patients with and without coronary artery lesions and healthy controls.
  • To identify factors associated with endothelial dysfunction following KD.

Main Methods:

  • Prospective enrollment of 46 children: 9 with KD and coronary artery lesions (Group 1), 15 with KD without lesions (Group 2), and 22 healthy controls (Group 3).
  • Evaluation of flow-mediated dilatation (FMD) of the brachial artery and intima-media thickness of the common carotid artery.
  • Statistical analysis to compare endothelial function parameters and identify correlations with clinical factors, including fever duration.

Main Results:

  • Children with KD exhibited significantly lower percent FMD (%FMD) compared to healthy controls.
  • %FMD was reduced in KD patients with coronary artery lesions compared to those without lesions and controls.
  • A significant negative correlation was observed between %FMD and the total duration of fever (r = -0.50; P = .013).

Conclusions:

  • Children with KD demonstrate arterial endothelial dysfunction within five years of disease onset.
  • The duration of fever in KD is a significant factor contributing to inflammation-induced endothelial dysfunction.
  • These findings underscore the potential for long-term vascular complications in children following Kawasaki disease.
Abstract

Keywords:
%FMD%GTNC-reactive proteinCALCRPCoronary artery lesionECGElectrocardiographyFMDFlow-mediated dilatationGTNGlyceryl trinitrateHDL-CHigh-density lipoprotein cholesterolIMTIVIGIntima-media thicknessIntravenous immunoglobulinKDKawasaki diseaseLDL-CLow-density lipoprotein cholesterolPercent FMDPercent GTNTCTotal cholesterol

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