Akita University Graduate School of Medicine, Organ Function-Oriented Medicine, Department of Pediatrics, Akita, Japan.
J Am Soc Echocardiogr. 2012 Jun;25(6):690-6. doi: 10.1016/j.echo.2012.03.003. Epub 2012 Apr 10.
Recent evidence has suggested that patients display altered arterial elasticity after Kawasaki disease (KD). However, changes in the elastic properties of the central aorta and their relevance to left ventricular geometry have not been studied in patients after KD with and without coronary artery aneurysms (CAAs).
Clinical and laboratory characteristics of 75 patients with KD were compared with those of 57 controls. The patients with KD included 17 patients with CAAs and 58 patients without CAAs. Values for aortic stiffness index, aortic distensibility, aortic strain, and left ventricular mass index (LVMI) were retrospectively obtained from echocardiographic measurements of the ascending aorta and left ventricle with noninvasive blood pressure evaluation.
Systolic blood pressure, pulse pressure, LVMI, and aortic stiffness index were significantly higher and aortic distensibility and aortic strain significantly lower in patients with KD than in the controls. In patients with KD, age at the time of study, interval between the onset of KD and the initiation of this study, CAAs, and LVMI were significantly associated with aortic stiffness index, aortic distensibility, and aortic strain. Multivariate analysis revealed that CAAs and LVMI were independently relevant to aortic stiffness index and aortic distensibility.
The central aortas of patients after KD have altered elastic properties. CAAs and LVMI are independently correlated with central aortic elasticity.
最近的证据表明,川崎病(KD)后患者的动脉弹性发生改变。然而,KD 患者有无冠状动脉瘤(CAA)时,其中心主动脉弹性的变化及其与左心室几何结构的相关性尚未得到研究。
将 75 例 KD 患者的临床和实验室特征与 57 例对照者进行比较。KD 患者包括 17 例 CAA 患者和 58 例无 CAA 患者。通过非侵入性血压评估,从升主动脉和左心室的超声心动图测量中回顾性获得主动脉僵硬指数、主动脉扩张性、主动脉应变和左心室质量指数(LVMI)的值。
与对照组相比,KD 患者的收缩压、脉压、LVMI 和主动脉僵硬指数明显升高,主动脉扩张性和主动脉应变明显降低。在 KD 患者中,研究时的年龄、KD 发病与本研究开始之间的间隔、CAA 和 LVMI 与主动脉僵硬指数、主动脉扩张性和主动脉应变显著相关。多变量分析显示,CAA 和 LVMI 与主动脉僵硬指数和主动脉扩张性独立相关。
KD 后患者的中心主动脉弹性发生改变。CAA 和 LVMI 与中心主动脉弹性独立相关。