Division of Pediatric Cardiology, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Quebec, Canada.
J Am Soc Echocardiogr. 2013 Dec;26(12):1388-96. doi: 10.1016/j.echo.2013.08.022. Epub 2013 Oct 4.
The long-term sequelae of Kawasaki disease (KD) are based on the coronary complications. Because KD causes generalized vasculitis, with documented aneurysms in the femoral, iliac, renal, axillary, and brachial arteries, the aim of this study was to assess the biophysical properties of the aorta (BPA) after KD. The BPA are biometric measurements representing vascular structural and dynamic changes in response to cardiac work.
Anthropometric and echocardiographic measurements of the aorta in a series of patients with KD were compared with those of healthy subjects. The BPA were calculated noninvasively by extrapolating previously validated equations that were conceived for invasive measurements. Because BPA vary with body habitus, control subjects were used to normalize BPA parameters for height to compute BPA Z-score equations.
Between June 2007 and February 2010, BPA were recorded in 57 patients with KD >1 year after the onset of the disease, 45 without and 12 with coronary artery sequelae. The mean intervals between the acute onset of KD and enrollment were 10.0 ± 5.0 and 5.8 ± 4.5 years for patients with and without coronary artery sequelae, respectively (P = .008). Patients with KD with coronary artery sequelae had significantly altered Z scores of aortic diameter modulation, Peterson's elastic modulus, and β stiffness index (P = .001-.016). Patients with KD without coronary artery sequelae also exhibited altered elasticity, stiffness, and pulse-wave velocity (P = .001-.026).
Altered BPA after KD are detectible despite apparent resolution of acute vasculitis. Future directions toward determining multilevel and multilayer vascular impact, including vascular autonomous homeostasis, require thorough investigation.
川崎病（KD）的长期后遗症基于冠状动脉并发症。由于 KD 引起全身性血管炎，股、髂、肾、腋、肱动脉均有记录到动脉瘤，因此本研究旨在评估 KD 后的主动脉生物物理特性（BPA）。BPA 是生物计量学测量值，代表了血管结构和动态变化，以应对心脏工作。
对一系列 KD 患者的主动脉进行人体测量学和超声心动图测量，并与健康受试者进行比较。BPA 通过外推以前为侵入性测量而设想的经过验证的方程进行非侵入性计算。由于 BPA 随身体形态而变化，因此使用对照者来标准化身高的 BPA 参数，以计算 BPA Z 分数方程。
2007 年 6 月至 2010 年 2 月，记录了 57 例 KD 患者的 BPA，这些患者在疾病发作后 1 年以上，其中 45 例无冠状动脉后遗症，12 例有冠状动脉后遗症。KD 患者发生急性发作至入组的平均间隔时间分别为有和无冠状动脉后遗症的患者为 10.0±5.0 和 5.8±4.5 年（P=0.008）。有冠状动脉后遗症的 KD 患者的主动脉直径调节、Peterson 弹性模量和β僵硬度指数的 Z 分数明显改变（P=0.001-0.016）。无冠状动脉后遗症的 KD 患者也表现出弹性、僵硬和脉搏波速度的改变（P=0.001-0.026）。
尽管急性血管炎明显缓解，但 KD 后 BPA 的改变仍然可以检测到。需要进行彻底的研究，以确定多层和多层血管的影响，包括血管自主稳态。
