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Updated: Apr 20, 2026
Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
Published on: October 22, 2014
Endothelial dysfunction by flow-mediated dilation assessed ultrasonically in patients with Kawasaki Disease
Harumi Koibuchi1, Kazuhiko Kotani, Takaomi Minami
1Department of Clinical Laboratory Medicine, Jichi Medical University, Shimotsuke-City, Japan - Kazukotani@jichi.ac.jp.
Insights
Kawasaki Disease (KD) may cause endothelial dysfunction, indicated by lower flow-mediated dilation (FMD) in children. However, more research is needed to confirm this link and its clinical utility for vascular complications.
Area of Science:
- Pediatric Cardiology
- Vascular Biology
- Rheumatology
Background:
- Kawasaki Disease (KD) is a critical pediatric illness.
- Coronary aneurysms are a severe complication of KD.
- Endothelial dysfunction is implicated in KD's vascular pathology.
Purpose of the Study:
- To systematically review studies on endothelial function in KD patients.
- To evaluate endothelial dysfunction using flow-mediated dilation (FMD).
- To assess the utility of FMD in managing KD vascular complications.
Main Methods:
- Systematic review of PubMed-published clinical studies up to 2013.
- Ultrasonic assessment of flow-mediated dilation (FMD) to measure endothelial function.
- Comparison of FMD levels between KD patients and control groups.
Main Results:
- Six of eight reviewed studies reported significantly lower FMD in KD patients.
- Two studies found no significant difference in FMD between KD patients and controls.
- Evidence suggests potential endothelial dysfunction in KD, but findings are inconsistent.
Conclusions:
- Patients with Kawasaki Disease may exhibit endothelial dysfunction.
- Current evidence is limited by small study sizes and lack of prospective vascular outcome data.
- Further research is required to definitively establish FMD's role in KD and its vascular complications.
Abstract:
Kawasaki Disease (KD) is a febrile disorder seen in infants and young children. One of the most serious complications of the disease is coronary aneurysm. Endothelial dysfunction is considered to underlie the etiopathology of coronary aneurysm. Flow-mediated dilation (FMD), as assessed ultrasonically, is used to observe the endothelial function. The current paper summarizes, by providing a systematic review, the clinical studies that have examined endothelial dysfunction by determining the FMD ultrasonically in patients with KD. A PubMed-based search found eight articles published until 2013. Six studies reported the FMD level to be significantly lower in the patients with KD compared to controls, while two studies reported no significant difference in the FMD level between those with and without KD. Although patients with KD appeared to have endothelial dysfunction in the current summary, most reports have been associated with limitations, such as a small size and no prospective design for vascular outcomes. Further studies are therefore needed to draw definite conclusions regarding whether patients with KD suffer from endothelial dysfunction as determined by the FMD and/or whether this determination can be useful for understanding and managing vascular complications in these patients.
