Department of Pediatric Cardiology, University Children's Hospital Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany.
Department of Pediatric Cardiology and Pediatric Intensive Care, Hospital of the University of Munich, Ludwig Maximilians University Munich, 81377, Munich, Germany.
Sci Rep. 2024 Oct 26;14(1):25547. doi: 10.1038/s41598-024-77345-2.
Kawasaki Disease (KD) is a multisystemic vasculitis of medium- and small-sized arteries. Abnormal intimal thickening may develop in the involved arterial area after regression of coronary artery aneurysm (CAA). Intimal dysfunction may induce local stenosis or arteriosclerosis in the future. In this case-control study, we investigated 29 consecutive KD patients [20 male, median current age, 7.9 years; median follow-up duration, 5.7 years] and a group of 29 healthy matched controls (CON) [19 male, median current age, 10.8 years]. They were assesed and compared for CAA, LVFS, GCS, GLS, coronary artery (CA) Z scores, carotid intima-media thickness (IMT) and coronary artery IMT by high-resolution transthoracic echocardiography (hrTTE). Coronary artery IMT (caIMT) was significantly higher in patients with a maximal CA Z score > 2.5 in acute KD than in CON: KD caIMT: 0.62 mm [IQR, 0.57-0.72 mm] vs. 0.53 mm [0.51-0.60 mm], p = 0.043. CAAs were found in 15 (51.7%) patients with acute KD. The maximal median LCA Z score in acute KD was 2.57z [IQR, 1.93-3.2z] and in follow-up -0.39z [IQR, -1.25 to -0.36z]. There was no significant difference in carotid IMT between KD patients and CON. Signs of CA intima-media thickening were detected by hrTTE in patients with a maximal CA Z score > 2.5 in acute KD. These data indicate that these patients may be at risk for cardiovascular sequale even in the absence of permanent CA luminal abnormalities. Therefore long-term follow-up of this group of KD patients may be required.
川崎病（KD）是一种中、小动脉的全身性血管炎。在冠状动脉瘤（CAA）消退后，受累动脉区域可能会出现异常的内膜增厚。内膜功能障碍可能会导致局部狭窄或未来的动脉硬化。在这项病例对照研究中，我们研究了 29 例连续的 KD 患者[20 例男性，中位当前年龄为 7.9 岁；中位随访时间为 5.7 年]和一组 29 名健康匹配的对照者（CON）[19 例男性，中位当前年龄为 10.8 岁]。通过高分辨率经胸超声心动图（hrTTE）评估并比较了 CAA、左心室射血分数（LVFS）、GCS、GLS、冠状动脉（CA）Z 评分、颈动脉内膜-中层厚度（IMT）和冠状动脉 IMT。与 CON 相比，在急性 KD 中最大 CA Z 评分>2.5 的患者中，冠状动脉 IMT（caIMT）显著更高：KD caIMT：0.62mm[IQR，0.57-0.72mm] vs. 0.53mm[0.51-0.60mm]，p=0.043。在 15 例（51.7%）急性 KD 患者中发现了 CAA。急性 KD 时最大中位 LCA Z 评分是 2.57z[IQR，1.93-3.2z]，随访时是-0.39z[IQR，-1.25 至-0.36z]。KD 患者和 CON 之间的颈动脉 IMT 没有显著差异。在急性 KD 中最大 CA Z 评分>2.5 的患者中，通过 hrTTE 检测到 CA 内-中膜增厚的迹象。这些数据表明，即使没有永久性 CA 管腔异常，这些患者也可能存在心血管后遗症的风险。因此，可能需要对这组 KD 患者进行长期随访。
