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Increased aortic intima-media thickness following Kawasaki disease
Katherine Yh Chen1, Diana Zannino2, Nigel Curtis1
1Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Victoria, Australia; Infectious Diseases Unit and Department of General Medicine, The Royal Children's Hospital Melbourne, Victoria, Australia.
Insights
Kawasaki disease patients show increased aortic stiffness and reduced carotid artery flexibility, indicating higher cardiovascular risk, particularly those with coronary artery abnormalities. Further research is needed to monitor these risks long-term.
Area of Science:
- Cardiovascular Medicine
- Pediatric Cardiology
- Vascular Biology
Background:
- Cardiovascular risk in Kawasaki disease (KD) survivors, especially those without persistent coronary artery abnormalities, remains unclear.
- Assessing early atherosclerosis markers in KD patients is crucial for long-term health management.
- Investigating subclinical cardiovascular changes can inform future preventative strategies.
Purpose of the Study:
- To evaluate subclinical atherosclerosis markers in individuals after Kawasaki disease.
- To compare arterial structure and function between KD patients and healthy controls.
- To identify potential cardiovascular risks associated with coronary artery status post-KD.
Main Methods:
- A cross-sectional case-control study involving 60 KD patients and 60 controls, at least two years post-KD.
- Non-invasive assessments included carotid and aortic intima-media thickness (IMT) and arterial stiffness measures.
- Statistical analyses adjusted for traditional cardiovascular risk factors.
Main Results:
- Kawasaki disease patients exhibited significantly increased aortic IMT compared to controls (p=0.04).
- Patients with coronary artery abnormalities showed reduced carotid artery distensibility (p=0.02).
- No significant differences were observed in carotid IMT between groups.
Conclusions:
- Kawasaki disease is associated with increased aortic IMT and reduced carotid distensibility, suggesting elevated cardiovascular risk.
- Coronary artery abnormalities in KD patients are linked to poorer arterial function.
- These findings highlight the need for ongoing cardiovascular surveillance in KD survivors.
Background And Aims:
The cardiovascular risk following Kawasaki disease (KD), especially in those without coronary artery changes or with regressed coronary artery lesions, is unclear. We assessed markers of early atherosclerosis in individuals following KD, including those with and without coronary artery abnormalities.
Methods:
We performed a cross-sectional case-control study of 60 patients (25 with always normal coronary arteries and 35 with abnormalities) and 60 controls, at least two years after KD. Non-invasive assessment of arterial structure (carotid and aortic intima-media thickness (IMT)) and function (pulse wave velocity, carotid artery distensibility and diameter compliance) was done. Analyses were adjusted for traditional cardiovascular risk factors.
Results:
Kawasaki disease patients had increased aortic IMT compared to controls (0.53 mm (95% CI 0.51-0.56) versus 0.49 (95% CI 0.47-0.52), p = 0.04), largely driven by those with abnormal coronary arteries. There were no differences in carotid IMT. Kawasaki disease patients with coronary artery abnormalities had reduced carotid distensibility compared to controls (15.16% (95% CI 13.67-16.65) versus 17.50 (95% CI 16.43-18.58), p = 0.02).
Conclusions:
Patients with KD have increased aortic IMT and reduced carotid distensibility, indicating heightened cardiovascular risk, especially in those with coronary artery abnormalities. In our study, we used validated surrogates for cardiovascular disease risk. Our findings, therefore, warrant follow-up investigations in KD patients.