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基于专家意见的川崎病心血管评估及随访实用工作流程

Practical Workflow for Cardiovascular Assessment and Follow-Up in Kawasaki Disease Based on Expert Opinion.

作者信息

van Stijn Diana, Planken R Nils, Groenink Maarten, Blom Nico, de Winter Robbert J, Kuijpers Taco, Kuipers Irene

机构信息

Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam, Netherlands.

Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam, Netherlands.

出版信息

Front Pediatr. 2022 Jun 9;10:873421. doi: 10.3389/fped.2022.873421. eCollection 2022.

Abstract

BACKGROUND

Approximately 25% of the patients with a history of Kawasaki disease (KD) develop coronary artery pathology if left untreated, with coronary artery aneurysms (CAA) as an early hallmark. Depending on the severity of CAAs, these patients are at risk of myocardial ischemia, infarction and sudden death. In order to reduce cardiac complications it is crucial to accurately identify patients with coronary artery pathology by an integrated cardiovascular program, tailored to the severity of the existing coronary artery pathology.

METHODS

The development of this practical workflow for the cardiovascular assessment of KD patients involve expert opinions of pediatric cardiologists, infectious disease specialists and radiology experts with clinical experience in a tertiary KD reference center of more than 1000 KD patients. Literature was analyzed and an overview of the currently most used guidelines is given.

CONCLUSIONS

We present a patient-specific step-by-step, integrated cardiovascular follow-up approach based on expert opinion of a multidisciplinary panel with expertise in KD.

摘要

背景

约25%有川崎病(KD)病史的患者若不接受治疗会出现冠状动脉病变,冠状动脉瘤(CAA)是早期标志。根据CAA的严重程度,这些患者有心肌缺血、梗死和猝死风险。为减少心脏并发症,通过根据现有冠状动脉病变严重程度量身定制的综合心血管项目准确识别有冠状动脉病变的患者至关重要。

方法

该KD患者心血管评估实用工作流程的制定涉及儿科心脏病专家、传染病专家和放射学专家的专业意见,这些专家在一个拥有1000多名KD患者的三级KD参考中心有临床经验。对文献进行了分析,并给出了当前最常用指南的概述。

结论

我们基于一个在KD方面具有专业知识的多学科小组的专家意见,提出了一种针对患者的逐步综合心血管随访方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b16/9218184/4e3b2607cd1c/fped-10-873421-g0001.jpg

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