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Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
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Late Wall Thickening and Calcification in Patients After Kawasaki Disease

Nobuyuki Tsujii1, Etsuko Tsuda1, Suzu Kanzaki2

  • 1Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Japan.

The Journal of Pediatrics
|November 14, 2016
PubMed

Insights

Initial coronary artery dilatation exceeding ~5.0 mm in Kawasaki disease (KD) can cause late coronary wall thickening and calcification (CAC). The risk of CAC increases with age and shows sex-based differences in coronary artery lesions.

Area of Science:

  • Cardiology
  • Pediatric Rheumatology
  • Radiology

Background:

  • Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
  • Coronary artery abnormalities, including aneurysms and calcification, are significant long-term complications.
  • Understanding the early predictors of these late complications is crucial for patient management.

Purpose of the Study:

  • To investigate the relationship between initial coronary artery diameters in Kawasaki disease patients and the development of late coronary wall thickening and calcification.
  • To determine cutoff points for acute coronary artery dilatation that predict future coronary artery calcification (CAC).
  • To identify risk factors, including sex, associated with late CAC in Kawasaki disease.

Main Methods:

  • Retrospective study of 65 patients with Kawasaki disease who underwent coronary angiography within 100 days of onset.
  • Dual-source computed tomography (DSCT) was used for late assessment of coronary wall thickening and CAC.
  • Coronary artery segments were analyzed, with the cohort divided into branches group (BG) and left coronary artery (LCA) bifurcation group.

Main Results:

  • Cutoff points for acute coronary dilatation predicting increased wall thickening were 4.8 mm in the BG and 5.3 mm in the LCA group.
  • The time interval from KD onset and patient sex were significant risk factors for CAC in the BG.
  • The prevalence of CAC increased with age, and a sex-based difference in CAC incidence within coronary artery lesions was observed.

Conclusions:

  • Coronary artery dilatation exceeding approximately 5.0 mm in the acute phase of Kawasaki disease is associated with late coronary artery wall abnormalities.
  • Age and sex are important factors influencing the development of late coronary artery calcification in patients with a history of Kawasaki disease.
Abstract

Keywords:
Kawasaki diseasecomputed tomography angiographycoronary artery calcificationcoronary artery lesiondual-source computed tomography

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