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Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
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Long-term outcome of coronary artery dilatation in Kawasaki disease

Najib Advani1, Sudigdo Sastroasmoro1, Teddy Ontoseno2

  • 1Department of Child Health, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Annals of Pediatric Cardiology
|June 21, 2018
PubMed

Insights

Most Kawasaki disease (KD) coronary artery dilatations regress within two years, especially smaller ones. Giant aneurysms often persist, with outcomes depending on diameter, not location.

Area of Science:

  • Pediatric Cardiology
  • Systemic Vasculitis Research
  • Medical Imaging in Pediatrics

Background:

  • Kawasaki disease (KD) is a significant cause of acquired heart disease in children, characterized by systemic vasculitis.
  • Coronary artery aneurysms are a common complication of KD, but many regress spontaneously over time.
  • Understanding the natural history of coronary artery dilatation in KD is crucial for patient management.

Purpose of the Study:

  • To investigate the long-term course and resolution of coronary artery dilatation in children diagnosed with Kawasaki disease.
  • To evaluate the factors influencing the regression of coronary artery aneurysms, including size and location.
  • To compare outcomes across different coronary artery branches affected by dilatation.

Main Methods:

  • Retrospective cohort study analyzing midterm follow-up data of KD patients with coronary dilatation.
  • Serial echocardiography utilized for monitoring coronary artery dimensions over 1-10.5 years.
  • Kaplan-Meier survival analysis applied to assess regression rates and time to resolution.

Main Results:

  • Out of 154 patients, 33.3% had coronary dilatation in the acute phase, decreasing to 7.9% by 6-8 weeks.
  • A total of 245 dilatations were observed, with a median regression time of 2.6 months (mean 10.5 months) over a median follow-up of 41 months.
  • Small and medium dilatations showed significantly better regression outcomes than giant aneurysms; location did not impact the outcome.

Conclusions:

  • The majority of small-to-medium coronary dilatations in KD regress within two years, while giant aneurysms are more likely to persist.
  • Coronary artery dilatation outcomes are primarily dictated by aneurysm diameter, not anatomical location.
  • Regression rates are inversely correlated with dilatation size, with smaller lesions resolving faster.
Abstract

Keywords:
Coronary dilatationKawasaki diseaselong-term outcome

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