Related Experiment Video
Updated: May 9, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Vascular health in Kawasaki disease
Elif Seda Selamet Tierney1, Dana Gal2, Kimberly Gauvreau2
1Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Pediatric Cardiology, Department of Pediatrics, Stanford University, Stanford, California.
Insights
Kawasaki disease (KD) patients show normal peripheral vascular health indices, including endothelial function and intima-media thickness, years after illness. This study provides reassurance for long-term vascular outcomes in individuals with a history of KD.
Area of Science:
- Cardiovascular Research
- Pediatric Cardiology
- Vascular Biology
Background:
- Conflicting literature exists regarding peripheral vascular health following Kawasaki disease (KD).
- Long-term vascular sequelae in KD patients require further investigation.
Purpose of the Study:
- To compare vascular health indices in Kawasaki disease (KD) patients with healthy controls.
- To assess endothelial function, carotid intima-media thickness (IMT), and arterial stiffness in a cohort of KD survivors.
Main Methods:
- A cohort of 203 KD patients (11-29 years old, KD onset >12 months prior) and 50 controls were evaluated.
- Vascular parameters included Endothelial Pulse Amplitude Testing (Endo-PAT) index, carotid IMT (RCCA/LCCA), lipid profile, and C-reactive protein (CRP).
- KD patients were stratified by coronary artery (CA) status: normal, mild ectasia, aneurysm, or giant aneurysm.
Main Results:
- KD patients exhibited higher peak velocity and pulsatility index in the left common carotid artery (LCCA) compared to controls.
- No significant differences were observed in Endothelial Pulse Amplitude Testing (Endo-PAT) index, carotid intima-media thickness (IMT), or arterial stiffness.
- Mean LCCA IMT showed a trend towards difference across groups, with a higher mean in the giant aneurysm group (Group IV).
Conclusions:
- Kawasaki disease (KD) patients with normal or mildly ectatic coronary arteries demonstrate normal peripheral vascular health indices.
- Findings suggest reassurance regarding peripheral vascular health in KD survivors, contrasting some prior reports.
- Long-term vascular assessment in KD patients is crucial, particularly for those with coronary artery abnormalities.
Objectives:
The objective of our study was to compare the indices of vascular health in Kawasaki disease (KD) patients to those of control subjects.
Background:
The literature on peripheral vascular health after KD is conflicting.
Methods:
Subjects were patients 11 to 29 years of age with the onset of KD >12 months before the study visit (n = 203) and healthy control subjects (n = 50). We measured endothelial function (using the Endothelial Pulse Amplitude Testing index), intima-media thickness (IMT) of the right common carotid artery (RCCA) and the left common carotid artery (LCCA), and fasting lipid profile and C-reactive protein (CRP). KD patients were classified according to their worst-ever coronary artery (CA) status: group I, always normal CAs (n = 136, 67%); group II, CA z-scores ≥2 but <3 (n = 20, 10%); group III, CA aneurysm z-scores ≥3 but <8 mm (n = 40, 20%); and group IV, giant CA aneurysm, defined as ≥8 mm (n = 7, 3%).
Results:
At a median of 11.6 years (range, 1.2 to 26 years) after KD onset, compared with controls, KD patients had a higher peak velocity in the LCCA (p = 0.04) and higher pulsatility index of both the RCCA and LCCA (p = 0.006 and p = 0.05, respectively). However, there were no differences in the Endo-PAT index or carotid IMT or stiffness. The mean IMT of the LCCA tended to differ across the KD subgroups and control group (p = 0.05), with a higher mean in group IV. Otherwise the KD subgroups and control group had similar vascular health indexes.
Conclusions:
In contrast to some earlier reports, our study of North American children and young adults demonstrated that KD patients whose maximum CA dimensions were either always normal or mildly ectatic have normal vascular health indexes, providing reassurance regarding peripheral vascular health in this population.
Related Concept Videos
01:23Rheumatic Heart Disease I: Introduction
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:20Rheumatic Heart Disease IV: Nursing Management
01:21Rheumatic Heart Disease III: Medical Management
01:25Endocarditis II: Clinical Features of Infective Endocarditis
01:26Coronary Artery Disease II: Pathophysiology