Abstract OBJECTIVE: To evaluate the late endothelial function in children with coronary aneurysm due to Kawasaki disease (KD). METHODS: Thirty-one children with coronary aneurysms due to KD who had the disease course for more than 1 year and twenty-one age-matched healthy children were enrolled. Brachial artery endothelium-dependent and -independent flow-mediated dilation (FMD), carotid arterial stiffness index (SI) and intima-media thickness (IMT) were measured by high-frequency ultrasound. RESULTS: There were 9 cases of medium and 22 cases of giant coronary aneurysms in the KD group. Twelve KD patients had evidence of myocardial ischemia. Compared to the normal controls, the endothelium-dependent FMD decreased (P<0.05), the carotid arterial SI increased (P<0.05), and the carotid arterial intima-media thickness increased significantly (P<0.05) in children with coronary aneurysms due to KD. The endothelium-dependent FMD decreased more significantly in 12 KD patients with myocardial ischemia than in those without any evidence of myocardial ischemia (P<0.05).ConclusionsLate endothelial dysfunction exists in children with coronary aneurysms due to KD, especially in those with myocardial ischemia.
DUAN Chao,DU Zhong-Dong,WANG Yu et al. Late endothelial function in children with coronary aneurysm due to Kawasaki disease[J]. 中国当代儿科杂志, 2011, 13(5): 373-376.
DUAN Chao,DU Zhong-Dong,WANG Yu et al. Late endothelial function in children with coronary aneurysm due to Kawasaki disease[J]. CJCP, 2011, 13(5): 373-376.
［1］Du ZD, Zhao D, Du J, Zhang YL, Lin Y, Liu C, et al. Epidemiologic study on Kawasaki disease in Beijing from 2000 through 2004［J］. Pediatr Infect Dis J, 2007, 26(5): 449-451.
［4］Stroes ES, Koomans HA, de Bruin TW,Rabelink TJ. Vascular function in the forearm of hypercholesterolaemic patients off and on lipid-lowering medication［J］. Lancet, 1995, 346(8973): 467-471.
［6］Japaness Circulation Society Joint Research Group. Guidelines for diagnosis and management of cardiovascular sequelae in Kawasaki disease［J］. Pediatr Int, 2005, 47(6): 711-732.
［7］Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association［J］. Pediatrics, 2004, 114(6): 1708-1733.
［8］Celermajer DS, Sorensen KE, Gooch VM, Spiegelhalter DJ, Miller OI, Sullivan ID, et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis［J］. Lancet, 1992, 340(8828): 1111-1115.
［9］Ikemoto Y, Ogino H, Teraguchi M, Kobayashi Y. Evaluation of preclinical atherosclerosis by flow-mediated dilatation of the brachial artery and carotid artery analysis in patients with a history of Kawasaki disease［J］. Pediatr Cardiol, 2005, 26(6): 782-786.
［10］Kadono T, Sugiyama H, Hoshiai M, Osada M, Tan T, Naitoh A, et al. Endothelial function evaluated by flow-mediated dilatation in pediatric vascular disease［J］. Pediatr Cardiol, 2005, 26(4): 385-390.
［11］Silva AA, Maeno Y, Hashmi A, Smallhorn JF, Silverman ED, McCrindle BW. Cardiovascular risk factors after Kawasaki disease: a case-control study［J］. J Pediatr, 2001, 138(3): 400-405.
［12］McCrindle BW, McIntyre S, Kim C, Lin T, Adeli K. Are patients after Kawasaki disease at increased risk for accelerated atherosclerosis?［J］. J Pediatr, 2007, 151(3): 244-248.
［13］Niboshi A, Hamaoka K, Sakata K, Yamaguchi N. Endothelial dysfunction in adult patients with a history of Kawasaki disease［J］. Eur J Pediatr, 2008, 167(2): 189-196.
［14］Dhillon R, Clarkson P, Donald AE, Powe AJ, Nash M, Novelli V, et al. Endothelial dysfunction late after Kawasaki disease［J］. Circulation, 1996, 94(9): 2103-2106.
［16］Belhassen L, Carville C, Pelle G, Monin JL, Teiger E, Duval-Moulin AM, et al. Evaluation of carotid artery and aortic intima-media thickness measurements for exclusion of significant coronary atherosclerosis in patients scheduled for heart valv suegery［J］. J Am Coll Cardiol, 2002, 39(7): 1139-1144.
［17］Cheung YF, Ho MH, Tam SC, Yung TC. Increased high sensitivity C-reactive protein concentrations and increased arterial stiffness in children with a history of Kawasaki disease［J］. Heart, 2004, 90(11): 1281-1285.
