Myocardial ischemia in Kawasaki disease: follow-up study by cardiac catheterization and coronary angiography.

The clinical course of ischemic heart disease due to Kawasaki disease was analyzed. The subjects (children aged two months to eight years) were divided into two groups. Group 1 (n = 23) consisted of children who had sustained myocardial infarction (MI) and group 2 (n = 13) of those without clinical symptoms or signs of MI, but in whom signs of an obstructive lesion had appeared on coronary arteriography during the follow-up period. Changes in the left ventricular ejection fraction (LVEF) and the appearance of coronary arterial lesions on first and second angiography were analyzed in the two groups. It was found that (a) LVEF (51.4 +/- 13.4%, mean +/- SD) at the first study, obtained after MI in group 1, was significantly lower than that (64.3 +/- 3.7%) at the second one in group 2, which revealed recently developed obstructive lesions; (b) there was no significant difference between the two groups as to the severity of stenotic lesions on coronary arteriography; and (c) comparison of LVEF at the first angiography with that at the second study showed significant improvement in group 1 (1st, 54.2 +/- 12.0%; and 2nd, 60.8 +/- 9.7%) and significant depression in group 2 (1st, 68.1 +/- 4.4%; and 2nd, 64.3 +/- 3.7%).