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Published on: October 22, 2014
KD Diagnosis Does Not Increase Cardiovascular Risk in Children According to Dynamic Intima-Media Roughness
Miriam König1, Theresa Ullmann2, Belén Pastor-Villaescusa1
1Department of Paediatric Cardiology, Ludwig-Maximilians-University of Munich, 81377 Munich, Germany.
Insights
This study found no significant differences in carotid intima-media roughness (cIMR) between children with a history of Kawasaki disease (KD) and healthy controls, suggesting KD may not lead to long-term general arteriopathy. Further research with larger cohorts is needed.
Area of Science:
- Pediatric Vasculitis Research
- Cardiovascular Risk Assessment
- Vascular Biology
Background:
- Kawasaki Disease (KD) is a childhood vasculitis with potential long-term cardiovascular implications.
- Standard markers like carotid intima-media thickness (cIMT) are not established for KD vascular anomalies.
- Carotid intima-media roughness (cIMR) is a promising surrogate marker for cardiovascular risk.
Purpose of the Study:
- To investigate if Kawasaki Disease (KD) history is associated with long-term alterations in carotid intima-media roughness (cIMR).
- To compare cIMR in KD patients versus healthy controls.
- To explore associations between KD clinical aspects and cIMR values.
Main Methods:
- A case-control study assessed cIMR in 44 KD patients and 36 controls.
- Participants were matched for sex and age.
- Coronary artery status and acute phase inflammation data were analyzed alongside cIMR.
Main Results:
- No significant difference in cIMR was found between KD patients and healthy controls.
- Disease severity indicators, including coronary artery aneurysms, did not correlate significantly with cIMR.
- A marginally significant finding suggested potentially rougher end-diastolic cIMR in KD patients compared to end-systolic values.
Conclusions:
- The study found no evidence that Kawasaki Disease (KD) predisposes patients to subsequent general arteriopathy based on cIMR.
- Results indicate cIMR is not a reliable long-term marker for KD-related vascular changes in this cohort.
- The findings require cautious interpretation due to the small sample size.
Background:
Kawasaki Disease (KD) is a generalized vasculitis in childhood with possible long-term impact on cardiovascular health besides the presence of coronary artery lesions. Standard vascular parameters such as carotid intima-media thickness (cIMT) have not been established as reliable markers of vascular anomalies after KD. The carotid intima-media roughness (cIMR) representing carotid intimal surface structure is considered a promising surrogate marker for predicting cardiovascular risk even beyond cIMT. We therefore measured cIMR in patients with a history of KD in comparison to healthy controls to investigate whether KD itself and/or KD key clinical aspects are associated with cIMR alterations in the long-term.
Methods:
We assessed cIMR in this case-control study (44 KD, mean age in years (SD); 13.4 (7.5); 36 controls, mean age 12.1 (5.3)) approximately matched by sex and age. Different clinical outcomes such as the coronary artery status and acute phase inflammation data were analyzed in association with cIMR values.
Results:
When comparing all patients with KD to healthy controls, we detected no significant difference in cIMR. None of the clinical parameters indicating the disease severity, such as the persistence of coronary artery aneurysm, were significantly associated with our cIMR values. However, according to our marginally significant findings (p = 0.044), we postulate that the end-diastolic cIMR may be rougher than the end-systolic values in KD patients.
Conclusions:
We detected no significant differences in cIMR between KD patients and controls that could confirm any evidence that KD predisposes patients to a subsequent general arteriopathy. Our results, however, need to be interpreted in the light of the low number of study participants.
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