Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-27T23:48:02.326Z Has data issue: false hasContentIssue false

Subclinical arterial stiffness in young children after Kawasaki disease

Published online by Cambridge University Press:  07 February 2013

Masato Oguri
Affiliation:
Department of Pediatrics, Kanazawa Medical University, Ishikawa, Japan
Tsuneyuki Nakamura*
Affiliation:
Department of Pediatrics, Kanazawa Medical University, Ishikawa, Japan Department of Pediatrics, Division of Cardiology, Children's Hospital Los Angeles, Los Angeles, United States of America
Keita Tamanuki
Affiliation:
Department of Pediatrics, Kanazawa Medical University, Ishikawa, Japan
Chisato Akita
Affiliation:
Department of Pediatrics, Kanazawa Medical University, Ishikawa, Japan
Chika Kitaoka
Affiliation:
Department of Pediatrics, Kanazawa Medical University, Ishikawa, Japan
Yutaka Saikawa
Affiliation:
Department of Pediatrics, Kanazawa Medical University, Ishikawa, Japan
Masato Takahashi
Affiliation:
Department of Pediatrics, Division of Cardiology, Children's Hospital Los Angeles, Los Angeles, United States of America
*
Correspondence to: Dr T. Nakamura, MD, PhD, Department of Pediatrics, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa 920-0293, Japan. Tel: +81-76-286-3511; Fax: +81-76-286-8918; E-mail: p-tune@kanazawa-med.ac.jp

Abstract

Background

Recent studies have revealed that atherosclerosis progresses faster than expected in young adults with a history of Kawasaki disease. However, it is unclear as to when these arterial changes become measurable. In this study, we evaluated subclinical arterial stiffness in young children with a history of Kawasaki disease using two-dimensional ultrasound speckle tracking.

Methods

A total of 75 children with a history of Kawasaki disease (mean age, 8.2 ± 2.8 years) and 50 healthy controls (mean age 8.3 ± 3.5 years) were included. The two regions of interest for speckle tracking were manually positioned at the anterior and posterior carotid arterial wall using a Philips iE33 (Philips Medical Systems, Bothell, WA, USA). The peak systolic strain, time to peak systolic strain, early systolic strain rate, and late systolic strain rate were continuously monitored between the two regions of interest. Furthermore, the intimal-medial thickness, stiffness β, and pressure-elastic modulus, as conventional measures of arterial stiffness, were concurrently obtained.

Results

The peak systolic strain and late systolic strain rate differed significantly between the patients with Kawasaki disease and controls (6.69% versus 8.60%, p < 0.01, and −0.28/second versus −0.51/second, p < 0.0001, respectively). There was no difference in the time to peak systolic strain, early systolic strain rate, and conventional measures.

Conclusions

The arteries of patients with Kawasaki disease appear to develop mild sclerotic changes shortly after the onset of the disease.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Kawasaki, T. Pediatric acute mucocutaneous lymph node syndrome: clinical observation of 50 cases. Arerugi (Jpn J Allergy) 1967; 16: 178222.Google Scholar
2. Yoshikawa, J, Yanagihara, K, Owaki, T, et al. Cross-sectional echocardiographic diagnosis of coronary artery aneurysms in patients with the mucocutaneous lymph node syndrome. Circulation 1979; 59: 133139.CrossRefGoogle ScholarPubMed
3. Suzuki, A, Kamiya, T, Kuwahara, N, et al. Coronary arterial lesions of Kawasaki disease: cardiac catheterization findings of 1100 cases. Pediatr Cardiol 1986; 7: 39.CrossRefGoogle ScholarPubMed
4. Laurent, F, Drouillard, J, Dorcier, F, Choussat, A, Tavernier, J. CT appearance of coronary aneurysm in Kawasaki disease. J Comput Assist Tomogr 1987; 11: 151152.CrossRefGoogle ScholarPubMed
5. Noto, N, Okada, T, Yamasuge, M, et al. Noninvasive assessment of the early progression of atherosclerosis in adolescents with Kawasaki disease and coronary artery lesions. Pediatrics 2001; 107: 10951099.Google Scholar
6. Noto, N, Okada, T, Karasawa, K, et al. Age-related acceleration of endothelial dysfunction and subclinical atherosclerosis in subjects with coronary artery lesions after Kawasaki disease. Pediatr Cardiol 2009; 30: 262268.Google Scholar
7. Riley, WA, Evans, GW, Sharrett, AR, Burke, GL, Barnes, RW. Variation of common carotid artery elasticity with intimal-medial thickness: the ARIC Study. Atherosclerosis Risk in Communities. Ultrasound Med Biol 1997; 23: 157164.Google Scholar
8. Celermajer, DS, Sorensen, KE, Gooch, VM, et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992; 340: 11111115.Google Scholar
9. Takahashi, K, Oharaseki, T, Naoe, S, Wakayama, M, Yokouchi, Y. Neutrophilic involvement in the damage to coronary arteries in acute stage of Kawasaki disease. Pediatr Int 2005; 47: 305310.CrossRefGoogle ScholarPubMed
10. Nakamura, T, Yamamura, J, Sato, H, Kakinuma, H, Takahashi, H. Vasculitis induced by immunization with Bacillus Calmette-Guérin followed by atypical mycobacterium antigen: a new mouse model for Kawasaki disease. FEMS Immunol Med Microbiol 2007; 49: 391397.Google Scholar
11. Peterson, LH, Jensen, RE, Parnell, J. Mechanical properties of arteries in vivo. Circ Res 1960; 8: 622639.Google Scholar
12. Hirai, T, Sasayama, S, Kawasaki, T, Yagi, S. Stiffness of systemic arteries in patients with myocardial infarction. A noninvasive method to predict severity of coronary atherosclerosis. Circulation 1989; 80: 7886.Google Scholar
13. Kawasaki, T, Fukuda, S, Shimada, K, et al. Direct measurement of wall stiffness for carotid arteries by ultrasound strain imaging. J Am Soc Echocardiogr 2009; 22: 13891395.Google Scholar
14. Oishi, Y, Mizuguchi, Y, Miyoshi, H, et al. A novel approach to assess aortic stiffness related to changes in aging using a two-dimensional strain imaging. Echocardiography 2008; 25: 941945.CrossRefGoogle ScholarPubMed
15. Kim, KH, Park, JC, Yoon, HJ, et al. Usefulness of aortic strain analysis by velocity vector imaging as a new echocardiographic measure of arterial stiffness. J Am Soc Echocardiogr 2009; 22: 13821388.CrossRefGoogle ScholarPubMed
16. Bjällmark, A, Lind, B, Peolsson, M, et al. Ultrasonographic strain imaging is superior to conventional non-invasive measures of vascular stiffness in the detection of age-dependent differences in the mechanical properties of the common carotid artery. Eur J Echocardiogr 2010; 11: 630636.Google Scholar
17. The Terminology Committee of the Japanese Society of Kawasaki Disease. http://www.jskd.jp/info/pdf/yougo201007.pdf, 2010.Google Scholar
18. Kobayashi, T, Inoue, Y, Takeuchi, K, et al. Prediction of intravenous immunoglobulin unresponsiveness in patients with Kawasaki disease. Circulation 2006; 113: 26062612.CrossRefGoogle ScholarPubMed
19. Nakamura, Y, Yashiro, M, Uehara, R, et al. Epidemiologic features of Kawasaki disease in Japan: results of the 2007–2008 nationwide survey. J Epidemiol 2010; 20: 302307.CrossRefGoogle ScholarPubMed
20. Kawasaki, T, Sasayama, S, Yagi, S, Asakawa, T, Hirai, T. Non-invasive assessment of the age related changes in stiffness of major branches of the human arteries. Cardiovasc Res 1987; 21: 678687.Google Scholar
21. Park, HE, Cho, GY, Kim, HK, Kim, YJ, Sohn, DW. Validation of circumferential carotid artery strain as a screening tool for subclinical atherosclerosis. J Atheroscler Thromb 2012; 19: 349356.Google Scholar
22. Kannel, WB, Hjortland, MC, McNamara, PM, et al. Meno-pause and risk of cardiovascular disease: the Framingham study. Ann Intern Med 1976; 85: 447452.CrossRefGoogle Scholar
23. Kodama, K, Sasaki, H, Shimizu, Y. Trend of coronary heart disease and its relationship to risk factors in a Japanese population: a 26-year follow-up, Hiroshima/Nagasaki study. Jpn Circ J 1990; 54: 414421.Google Scholar