Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Allergy Immunology Unit, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Cardiol Young. 2021 Jun;31(6):998-1002. doi: 10.1017/S1047951121000020. Epub 2021 Jan 28.
To evaluate whether Kawasaki disease predisposes to premature atherosclerosis and to assess status of coronary artery abnormalities at least 10 years after diagnosis.
A prospective study was carried out on 21 patients who were diagnosed with Kawasaki disease at least 10 years back and are on regular follow-up. The study was conducted on 128 Slice Dual Source computed tomography scanner with electrocardiography-triggered radiation optimised protocols for assessment of coronary artery abnormalities and calcifications.
Study cohort had 21 subjects - 15 males and 6 females (age range: 11-23 years; mean: 15.76 + 3.72 years). Mean age at time of diagnosis was 3.21 + 2.48 years. Mean time interval from diagnosis of Kawasaki disease to computed tomography coronary angiography was 12.59 + 2.89 years. Four children had evidence of coronary artery abnormalities on transthoracic echocardiography at time of diagnosis. Of these, two had persistent abnormalities on computed tomography coronary angiography. One subject (4.76%) had coronary calcification that was localised to abnormal coronary artery segment. Four coronary artery abnormalities (one saccular; three fusiform aneurysms) were noted in two subjects.
Prevalence of coronary artery calcification is low and, if present, is localised to abnormal segments. This calcification is likely dystrophic rather than atherosclerotic. It appears that coronary artery abnormalities can persist for several years after acute episode of Kawasaki disease. Periodic follow-up by computed tomography coronary angiography is now a feasible non-invasive imaging modality for long term surveillance of patients with Kawasaki disease who had coronary artery abnormalities at time of diagnosis.
评估川崎病是否导致早发动脉粥样硬化，并评估诊断后至少 10 年冠状动脉异常的状况。
对至少 10 年前被诊断为川崎病且正在定期随访的 21 例患者进行前瞻性研究。使用 128 层双源 CT 扫描仪进行研究，采用心电图触发的辐射优化方案进行冠状动脉异常和钙化评估。
研究队列包括 21 名患者 - 15 名男性和 6 名女性（年龄范围：11-23 岁；平均年龄：15.76 + 3.72 岁）。诊断时的平均年龄为 3.21 + 2.48 岁。从川崎病诊断到计算机断层扫描冠状动脉造影的平均时间间隔为 12.59 + 2.89 年。在诊断时，有 4 名儿童经胸超声心动图显示有冠状动脉异常。其中，2 名在计算机断层扫描冠状动脉造影上有持续性异常。1 名患者（4.76%）有冠状动脉钙化，局限于异常冠状动脉节段。两名患者有 4 个冠状动脉异常（1 个囊状；3 个梭形动脉瘤）。
冠状动脉钙化的患病率较低，而且如果存在，也局限于异常节段。这种钙化可能是营养不良性的，而不是动脉粥样硬化性的。川崎病急性发作后，冠状动脉异常可能会持续数年。现在，定期进行计算机断层扫描冠状动脉造影检查是一种可行的非侵入性成像方式，可用于长期监测诊断时有冠状动脉异常的川崎病患者。
