Assessment of Vascular and Endothelial Function in Kawasaki Disease

Overview

Journal Biomed J

Publisher Elsevier

Specialty General Medicine

Date 2022 Mar 31

PMID 35358713

Authors

Mao-Hung Lo

Ying-Jui Lin

Hsuan-Chang Kuo

Yi-Hua Wu

Tse-Yi Li

Ho-Chang Kuo

I-Chun Lin

Affiliations

Soon will be listed here.

Abstract

Background: Kawasaki disease (KD) is an acute febrile vasculitis. Patients with previous KD have increased risk of coronary arterial aneurysms (CAA) and early-onset arteriosclerosis. Endothelial dysfunction is the earliest manifestation of arteriosclerosis. We aimed to explore the endothelial function and clinical characteristics of patients with previous KD.

Methods: In this case-control study, we investigated childhood KD patients, with and without CAA, and a group of healthy controls. We obtained the anthropometric measurements, metabolic markers, vascular ultrasonography evaluating arterial stiffness and flow-mediated dilatation (FMD), and clinical information obtained by reviewing the patients' charts. Continuous variables were compared using non-parametric analyses and categorical variables, using the chi-square or Fisher's exact tests.

Results: Seventy KD patients (median current age, 12.95 years; median follow-up duration, 10.88 years) and 14 healthy controls were recruited. FMD was significantly lower in the CAA group (n = 15) than the control group (FMDs: 5.59% [interquartile range, 3.99-6.86%] vs. 7.49% [5.96-9.42%], p = 0.049; diastolic FMD: 6.48% [4.14-7.32%] vs. 7.87% [6.19-9.98%], p = 0.042). The CAA group had a higher percentage of impaired FMD and the significantly largest coronary segments of the three groups. Other parameters including metabolic markers, carotid intima-media thickness, and arterial stiffness were not statistically different.

Conclusion: KD patients, especially those with CAAs, may have impaired endothelial function. FMD may be a good indicator of endothelial dysfunction for use in long-term follow-up of KD patients.

Citing Articles

An Update on Kawasaki Disease.

Goel A, Yalcindag A Curr Rheumatol Rep. 2024; 27(1):4.

PMID: 39625646 DOI: 10.1007/s11926-024-01167-4.

Coronary Arteries Lesions in Kawasaki Disease: Risk Factors in an Italian Cohort.

Morana E, Guida F, Andreozzi L, Frazzoni L, Baselli L, Lami F Biomedicines. 2024; 12(9).

PMID: 39335523 PMC: 11429242. DOI: 10.3390/biomedicines12092010.

Semaphorin 7A promotes endothelial permeability and inflammation via plexin C1 and integrin β1 in Kawasaki disease.

Huang J, Zhao C, Zhang S BMC Pediatr. 2024; 24(1):285.

PMID: 38678170 PMC: 11055240. DOI: 10.1186/s12887-024-04766-3.

Markers of Endothelial Dysfunction in Kawasaki Disease: An Update.

Kumrah R, Goyal T, Rawat A, Singh S Clin Rev Allergy Immunol. 2024; 66(1):99-111.

PMID: 38462555 DOI: 10.1007/s12016-024-08985-5.

CircRNA7632 down-regulation alleviates endothelial cell dysfunction in Kawasaki disease via regulating IL-33 expression.

Qiu H, Ni C, Jia C, Rong X, Chu M, Wu R Cell Stress Chaperones. 2023; 28(4):363-374.

PMID: 37166618 PMC: 10352195. DOI: 10.1007/s12192-023-01333-0.

References

Glowinska-Olszewska B, Tolwinska J, Urban M . Relationship between endothelial dysfunction, carotid artery intima media thickness and circulating markers of vascular inflammation in obese hypertensive children and adolescents. J Pediatr Endocrinol Metab. 2007; 20(10):1125-36. View

Lorenz M, Markus H, Bots M, Rosvall M, Sitzer M . Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation. 2007; 115(4):459-67. DOI: 10.1161/CIRCULATIONAHA.106.628875. View

Ishikawa T, Seki K . The association between oxidative stress and endothelial dysfunction in early childhood patients with Kawasaki disease. BMC Cardiovasc Disord. 2018; 18(1):30. PMC: 5807819. DOI: 10.1186/s12872-018-0765-9. View

Urbina E, Williams R, Alpert B, Collins R, Daniels S, Hayman L . 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. 2009; 54(5):919-50. DOI: 10.1161/HYPERTENSIONAHA.109.192639. View

Aggoun Y, Szezepanski I, Bonnet D . Noninvasive assessment of arterial stiffness and risk of atherosclerotic events in children. Pediatr Res. 2005; 58(2):173-8. DOI: 10.1203/01.PDR.0000170900.35571.CB. View

Meena R, Rohit M, Gupta A, Singh S . Carotid intima-media thickness in children with Kawasaki disease. Rheumatol Int. 2013; 34(8):1117-21. DOI: 10.1007/s00296-013-2820-2. View

Kadono T, Sugiyama H, Hoshiai M, Osada M, Tan T, Naitoh A . Endothelial function evaluated by flow-mediated dilatation in pediatric vascular disease. Pediatr Cardiol. 2005; 26(4):385-90. DOI: 10.1007/s00246-004-0755-9. View

Silva A, Maeno Y, Hashmi A, Smallhorn J, Silverman E, McCrindle B . Cardiovascular risk factors after Kawasaki disease: a case-control study. J Pediatr. 2001; 138(3):400-5. DOI: 10.1067/mpd.2001.111430. View

Noto N, Okada T, Yamasuge M, Taniguchi K, Karasawa K, Ayusawa M . Noninvasive assessment of the early progression of atherosclerosis in adolescents with Kawasaki disease and coronary artery lesions. Pediatrics. 2001; 107(5):1095-9. DOI: 10.1542/peds.107.5.1095. View

10.

Gupta-Malhotra M, Gruber D, Abraham S, Roman M, Zabriskie J, Hudgins L . Atherosclerosis in survivors of Kawasaki disease. J Pediatr. 2009; 155(4):572-7. DOI: 10.1016/j.jpeds.2009.04.054. View

11.

Ishikawa T, Iwashima S . Endothelial dysfunction in children within 5 years after onset of Kawasaki disease. J Pediatr. 2013; 163(4):1117-21. DOI: 10.1016/j.jpeds.2013.04.046. View

12.

Noto N, Komori A, Ayusawa M, Takahashi S . Recent updates on echocardiography and ultrasound for Kawasaki disease: beyond the coronary artery. Cardiovasc Diagn Ther. 2018; 8(1):80-89. PMC: 5835648. DOI: 10.21037/cdt.2017.06.09. View

13.

Tomiyama H, Saisu T, Yamashina A . Measurement of Flow-Mediated Vasodilatation. Int Heart J. 2017; 58(2):158-162. DOI: 10.1536/ihj.17-013. View

14.

Corretti M, Anderson T, Benjamin E, Celermajer D, Charbonneau F, Creager M . Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol. 2002; 39(2):257-65. DOI: 10.1016/s0735-1097(01)01746-6. View

15.

Lo M, Lin I, Lu P, Huang C, Chien S, Hsieh K . Evaluation of endothelial dysfunction, endothelial plasma markers, and traditional metabolic parameters in children with adiposity. J Formos Med Assoc. 2018; 118(1 Pt 1):83-91. DOI: 10.1016/j.jfma.2018.01.007. View

16.

Niboshi A, Hamaoka K, Sakata K, Yamaguchi N . Endothelial dysfunction in adult patients with a history of Kawasaki disease. Eur J Pediatr. 2007; 167(2):189-96. DOI: 10.1007/s00431-007-0452-9. View

17.

de Ferranti S, Steinberger J, Ameduri R, Baker A, Gooding H, Kelly A . Cardiovascular Risk Reduction in High-Risk Pediatric Patients: A Scientific Statement From the American Heart Association. Circulation. 2019; 139(13):e603-e634. DOI: 10.1161/CIR.0000000000000618. View

18.

Deng Y, Xiang H, Chang Q, Li C . Evaluation by high-resolution ultrasonography of endothelial function in brachial artery after Kawasaki disease and the effects of intravenous administration of vitamin C. Circ J. 2002; 66(10):908-12. DOI: 10.1253/circj.66.908. View

19.

Dhillon R, Clarkson P, Donald A, Powe A, Nash M, Novelli V . Endothelial dysfunction late after Kawasaki disease. Circulation. 1996; 94(9):2103-6. DOI: 10.1161/01.cir.94.9.2103. View

20.

Lee S, Ahn H, You J, Hong Y . Carotid intima-media thickness and pulse wave velocity after recovery from kawasaki disease. Korean Circ J. 2009; 39(7):264-9. PMC: 2771822. DOI: 10.4070/kcj.2009.39.7.264. View