PEDIATRICS Vol. 107 No. 5 May 2001, pp. 1095-1099

Noninvasive Assessment of the Early Progression of Atherosclerosis in Adolescents With Kawasaki Disease and Coronary Artery Lesions

Received May 4, 2000; accepted Oct 3, 2000.

From the Department of Pediatrics and Cardiology, Nihon University School of Medicine, Tokyo, Japan.

Objectives.  The severity of carotid arteriosclerosis, defined as increased intima-media thickness (IMT) visible with B-mode ultrasound, is correlated with risk factors for coronary heart disease. Little is known, however, about the relation of IMT, the stiffness of the common carotid artery, and the progression of atherosclerosis in children with Kawasaki disease (KD) and coronary artery lesions (CAL).

Design.  We investigated the associations among total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) , low density lipoprotein cholesterol (LDL-C), triglyceride, TC/HDL-C, ApoE genotype, glycohemoglobin, IMT, and arterial stiffness by high resolution ultrasound in 20 adolescents with KD and CAL (age: 16.6 ± 4.1 years, males: 60%) and 20 sex- and age-matched healthy controls (Cont).

Results.  No significant differences were observed in the values of body mass index and blood pressure between the 2 groups. Also no significant differences were observed in the levels of TC, LDL-C, HDL-C, triglyceride, TC/HDL-C within normal values, or the allele frequency of Apo E4 between the 2 groups. However, the values of IMT, stiffness, and glycohemoglobin in patients with KD were significantly higher than those in Cont (0.53 ± 0.07 vs 0.46 ± 0.05 mm, P < .05; 4.11 ± 0.86 vs 2.94 ± 0.91, P < .001; 5.0 ± 0.4 vs 4.6 ± 0.2%, P < .05). A significant relationship was observed between sex and the mean IMT (r = 0.46) in Cont; however, no significant correlation was found between mean IMT and other variables in either group. Although the arterial stiffness was strongly related to body mass index (r = 0.58) and systolic blood pressure (r = 0.55) in Cont, no significant relationship was observed between the stiffness and any variable tested in patients with KD.

Conclusions.  The less distensible carotid wall in patients with KD compared with that in Cont without major alteration of the lipid profile is likely to be secondary to the changes in arterial walls after a diffuse vasculitis involving noncoronary arteries. These results indicate that the coronary arteries may be predisposed to accelerated atherosclerosis in patients with KD and CAL.  Key words:  Kawasaki disease, atherosclerosis, carotid artery, adolescent.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				J. B. Gordon, A. M. Kahn, and J. C. Burns When Children With Kawasaki Disease Grow Up: Myocardial and Vascular Complications in Adulthood J. Am. Coll. Cardiol., November 17, 2009; 54(21): 1911 - 1920. [Abstract] [Full Text] [PDF]

				E. M. Urbina, R. V. Williams, B. S. Alpert, R. T. Collins, S. R. Daniels, L. Hayman, M. Jacobson, L. Mahoney, M. Mietus-Snyder, A. Rocchini, et al. Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents: Recommendations for Standard Assessment for Clinical Research: A Scientific Statement From the American Heart Association Hypertension, November 1, 2009; 54(5): 919 - 950. [Abstract] [Full Text] [PDF]

				B. W. McCrindle Kawasaki Disease: A Childhood Disease With Important Consequences Into Adulthood Circulation, July 7, 2009; 120(1): 6 - 8. [Full Text] [PDF]

				H. Senzaki Long-Term Outcome of Kawasaki Disease Circulation, December 16, 2008; 118(25): 2763 - 2772. [Full Text] [PDF]

				Y.-f. Cheung, G.-y. Huang, S.-b. Chen, X.-q. Liu, L. Xi, X.-c. Liang, M.-r. Huang, S. Chen, L.-s. Huang, X.-q. Liu, et al. Inflammatory Gene Polymorphisms and Susceptibility to Kawasaki Disease and Its Arterial Sequelae Pediatrics, September 1, 2008; 122(3): e608 - e614. [Abstract] [Full Text] [PDF]

				Y-f Cheung, S J Wong, and M H K Ho Relationship between carotid intima-media thickness and arterial stiffness in children after Kawasaki disease Arch. Dis. Child., January 1, 2007; 92(1): 43 - 47. [Abstract] [Full Text] [PDF]

				R.-E. W. Kavey, V. Allada, S. R. Daniels, L. L. Hayman, B. W. McCrindle, J. W. Newburger, R. S. Parekh, and J. Steinberger Cardiovascular Risk Reduction in High-Risk Pediatric Patients: A Scientific Statement From the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: Endorsed by the American Academy of Pediatrics Circulation, December 12, 2006; 114(24): 2710 - 2738. [Abstract] [Full Text] [PDF]

				A. Covic, N. Mardare, P. Gusbeth-Tatomir, O. Brumaru, C. Gavrilovici, M. Munteanu, O. Prisada, and D. J. A. Goldsmith Increased arterial stiffness in children on haemodialysis Nephrol. Dial. Transplant., March 1, 2006; 21(3): 729 - 735. [Abstract] [Full Text] [PDF]

				J. Frostegard Atherosclerosis in Patients With Autoimmune Disorders Arterioscler Thromb Vasc Biol, September 1, 2005; 25(9): 1776 - 1785. [Abstract] [Full Text] [PDF]

				H. Senzaki, C.-H. Chen, H. Ishido, S. Masutani, T. Matsunaga, M. Taketazu, T. Kobayashi, N. Sasaki, S. Kyo, and Y. Yokote Arterial Hemodynamics in Patients After Kawasaki Disease Circulation, April 26, 2005; 111(16): 2119 - 2125. [Abstract] [Full Text] [PDF]

				J. W. Newburger, M. Takahashi, M. A. Gerber, M. H. Gewitz, L. Y. Tani, J. C. Burns, S. T. Shulman, A. F. Bolger, P. Ferrieri, R. S. Baltimore, et al. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association Pediatrics, December 1, 2004; 114(6): 1708 - 1733. [Abstract] [Full Text] [PDF]

				Y F Cheung, M H K Ho, S C F Tam, and T C Yung Increased high sensitivity C reactive protein concentrations and increased arterial stiffness in children with a history of Kawasaki disease Heart, November 1, 2004; 90(11): 1281 - 1285. [Abstract] [Full Text] [PDF]

				J. W. Newburger, M. Takahashi, M. A. Gerber, M. H. Gewitz, L. Y. Tani, J. C. Burns, S. T. Shulman, A. F. Bolger, P. Ferrieri, R. S. Baltimore, et al. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association Circulation, October 26, 2004; 110(17): 2747 - 2771. [Abstract] [Full Text] [PDF]

				Y.-f. Cheung, T.-c. Yung, S. C. F. Tam, M. H. K. Ho, and A. K. T. Chau Novel and traditional cardiovascular risk factors in children after Kawasaki disease: Implications for premature atherosclerosis J. Am. Coll. Cardiol., January 7, 2004; 43(1): 120 - 124. [Abstract] [Full Text] [PDF]

				H. C. Meissner and D. Y. M. Leung Kawasaki Syndrome: Where Are the Answers? Pediatrics, September 1, 2003; 112(3): 672 - 676. [Full Text] [PDF]

				C.-L. Wang, Y.-T. Wu, C.-A. Liu, M.-W. Lin, C.-J. Lee, L.-T. Huang, and K. D. Yang Expression of CD40 Ligand on CD4+ T-Cells and Platelets Correlated to the Coronary Artery Lesion and Disease Progress in Kawasaki Disease Pediatrics, February 1, 2003; 111(2): e140 - 147. [Abstract] [Full Text] [PDF]

				J. M. Sorof, A. V. Alexandrov, G. Cardwell, and R. J. Portman Carotid Artery Intimal-Medial Thickness and Left Ventricular Hypertrophy in Children With Elevated Blood Pressure Pediatrics, January 1, 2003; 111(1): 61 - 66. [Abstract] [Full Text] [PDF]