|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 1996; 27:291-296 © 1996 by the American College of Cardiology Foundation |
Department of Pediatrics, National Cardiovascular Center, Osaka, Japan.
OBJECTIVES. To examine the development of coronary artery lesions in Kawasaki disease, we assessed the functional behavior and morphology of coronary arteries by intravascular ultrasound. BACKGROUND. Long-term follow-up studies of patients with Kawasaki disease have demonstrated the development of localized coronary stenoses even after aneurysms have regressed. It is also possible that angiographically normal coronary segments in patients with this disease may retain histologic changes. METHODS. Twenty-three patients followed up by serial coronary angiography were examined at a mean age +/- SD of 14.9 +/- 2.9 years. The thickness of the intima-media complex was measured by intravascular ultrasound (30 MHz; 3.5 or 4.3 F; 1,800 rpm). Coronary reactivity to nitroglycerin was determined by measuring percent changes in cross-sectional coronary artery area after intracoronary injection (7 microgram/kg body weight) of this agent. RESULTS. A remarkably thickened intima-media complex was observed at the sites with persisting (0.54 +/- 0.20 mm, n = 19) and regressed (0.84 +/- 0.40 mm, n = 23) aneurysms. Mild thickening of the intima-media complex was often observed even in angiographically normal segments (0.22 +/- 0.05 mm, n = 31), in the left main coronary artery (0.47 +/- 0.15 mm, n = 20) and at normal branches (0.36 +/- 0.09 mm, n = 13). Coronary reactivity to nitroglycerin was significantly lower at the sites of regressed aneurysms (12.8 +/- 6.6%, n = 9) than in normal segments (32.8 +/- 10.9%, n = 13, p < 0.01), indicating the presence of functional impairment at the sites with regressed aneurysms. Decreased nitroglycerin reactivity was also observed in some segments without evidence of aneurysm. CONCLUSIONS. These results indicate that in patients with Kawasaki disease the coronary disease accompanying impaired reactivity to nitroglycerin is present at the sites of regressed aneurysms as well as in angiographically normal coronary segments. We suggest that these sites with morphologic and functional abnormalities are related to the development of significant stenosis.
This article has been cited by other articles:
|
|
 |
|
  S. R.F.F. Pedra, C. A.C. Pedra, A. A. Abizaid, S. L.N. Braga, R. Staico, R. Arrieta, J. R. Costa Jr, V. D. Vaz, V. F. Fontes, and J. E. R. Sousa Intracoronary Ultrasound Assessment Late After the Arterial Switch Operation for Transposition of the Great Arteries J. Am. Coll. Cardiol., June 21, 2005; 45(12): 2061 - 2068. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. W. Newburger, M. Takahashi, M. A. Gerber, M. H. Gewitz, L. Y. Tani, J. C. Burns, S. T. Shulman, A. F. Bolger, P. Ferrieri, R. S. Baltimore, 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 Pediatrics, December 1, 2004; 114(6): 1708 - 1733. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. W. Newburger, M. Takahashi, M. A. Gerber, M. H. Gewitz, L. Y. Tani, J. C. Burns, S. T. Shulman, A. F. Bolger, P. Ferrieri, R. S. Baltimore, 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 Circulation, October 26, 2004; 110(17): 2747 - 2771. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Furuyama, Y. Odagawa, C. Katoh, Y. Iwado, K. Yoshinaga, Y. Ito, K. Noriyasu, M. Mabuchi, Y. Kuge, K. Kobayashi, et al. Assessment of Coronary Function in Children With a History of Kawasaki Disease Using 15O-Water Positron Emission Tomography Circulation, June 18, 2002; 105(24): 2878 - 2884. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Eguchi, S. Kondoh, Y.-i. Takagi, K. Tsuchihashi, M. Abiru, Y. Minatoya, R. Seino, and Y. Fujise Giant Noninflammatory and Nonatherosclerotic Coronary Arterial Aneurysm in the Left Main Trunk Assessed by Intravascular Ultrasound Imaging: A Case Report Angiology, July 1, 2000; 51(7): 599 - 602. [Abstract] [PDF]
|
|
|
|
|
|
A. Suzuki, S. Miyagawa-Tomita, K. Komatsu, T. Nishikawa, Y. Sakomura, T. Horie, and M. Nakazawa Active Remodeling of the Coronary Arterial Lesions in the Late Phase of Kawasaki Disease : Immunohistochemical Study Circulation, June 27, 2000; 101(25): 2935 - 2941. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Iemura, M Ishii, T Sugimura, T Akagi, and H Kato Long term consequences of regressed coronary aneurysms after Kawasaki disease: vascular wall morphology and function Heart, March 1, 2000; 83(3): 307 - 311. [Abstract] [Full Text]
|
|
|
|
 |
|
 A. H. Rowley and S. T. Shulman Kawasaki Syndrome Clin. Microbiol. Rev., July 1, 1998; 11(3): 405 - 414. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. P. Burke, R. Virmani, L. W. Perry, L. Li, T. M. King, and J. Smialek Fatal Kawasaki Disease With Coronary Arteritis and No Coronary Aneurysms Pediatrics, January 1, 1998; 101(1): 108 - 108. [Full Text] [PDF]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
