Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
Department of Physiological Laboratory, National Cerebral and Cardiovascular Center, Osaka, Japan.
J Pediatr. 2021 Mar;230:133-139.e2. doi: 10.1016/j.jpeds.2020.12.004. Epub 2020 Dec 8.
To determine the timeframe in which coronary artery aneurysms (CAAs) caused by Kawasaki disease reach their maximum diameter, the timeframe in which they regress to normal size, and the cutoff point of the diameter for CAA regression.
We reviewed 195 CAAs of the right coronary artery, left anterior descending artery, and left coronary artery measured by 2-dimensional echocardiography ≥5 times for 1 year after Kawasaki disease in 84 patients using medical records from 1995. The maximum diameters of CAAs were investigated retrospectively. The time to CAA regression using both absolute diameter and Z score were investigated. The cutoff points of the diameter of CAA regression in the 2 classifications were identified using receiver operator characteristic curve analysis. One year after Kawasaki disease, a CAA of <3.0 mm in absolute diameter and a Z score of <2.5 were defined as CAA regression.
The time when CAAs reached their maximum diameter ranged from 11 days to 87 days, with a median of 35 days (n = 195). The time to CAA regression ranged from 41 to 386 days, with a median of 136 days in the absolute diameter classification (n = 92); 78% of CAA regression regressed by 200 days. The cutoff point for CAA regression at one year was 5.7 mm for the absolute diameter (area under the curve, 0.887; P < .0001; n = 190) and 9.5 for the Z score (area under the curve, 0.815; P < .0001; n = 195).
CAAs with a smaller diameter regressed earlier, and most CAAs of <6 mm regressed by 6 months after Kawasaki disease.
确定川崎病导致的冠状动脉瘤（CAA）达到最大直径的时间范围、瘤体回缩至正常大小的时间范围，以及 CAA 回缩的直径临界点。
我们回顾了 1995 年至 2015 年间，84 例川崎病患者的 2 维超声心动图检查的右冠状动脉、左前降支和左冠状动脉共 195 个 CAA，这些 CAA 至少随访 5 次，随访时间为 1 年。回顾性研究 CAA 的最大直径。使用绝对直径和 Z 评分研究 CAA 回缩的时间。使用受试者工作特征曲线分析确定 2 种分类中 CAA 回缩的直径临界点。川崎病 1 年后，绝对直径 <3.0mm 和 Z 评分 <2.5 的 CAA 定义为 CAA 回缩。
CAA 达到最大直径的时间范围为 11 天至 87 天，中位数为 35 天（n=195）。CAA 回缩的时间范围为 41 天至 386 天，在绝对直径分类中中位数为 136 天（n=92）；78%的 CAA 在 200 天内回缩。在 1 年时，绝对直径的 CAA 回缩临界点为 5.7mm（曲线下面积，0.887；P<0.0001；n=190），Z 评分的 CAA 回缩临界点为 9.5（曲线下面积，0.815；P<0.0001；n=195）。
直径较小的 CAA 更早回缩，大多数 <6mm 的 CAA 在川崎病后 6 个月内回缩。
