- 作者：Laurence Vaujois ; Fr茅d茅ric Dallaire ; Roch L. Maurice ; Anne Fournier ; Christine Houde ; Johanne Th茅rien ; Daniel Cartwright ; Nagib Dahdah
- 关键词：Mucocutaneous lymph node syndrome ; Systemic vasculitis ; Aortitis ; Sequelae
- 刊名：Journal of the American Society of Echocardiography
- 出版年：December, 2013
- 年：2013
- 卷：26
- 期：12
- 页码：1388-1396
- 全文大小：937 K
Background
The long-term sequelae of Kawasaki disease (KD) are based on the coronary complications. Because KD causes generalized vasculitis, with documented aneurysms in the femoral, iliac, renal, axillary, and brachial arteries, the aim of this study was to assess the biophysical properties of the aorta (BPA) after KD. The BPA are biometric measurements representing vascular structural and dynamic changes in response to cardiac work.Methods
Anthropometric and echocardiographic measurements of the aorta in a series of patients with KD were compared with those of healthy subjects. The BPA were calculated noninvasively by extrapolating previously validated equations that were conceived for invasive measurements. Because BPA vary with body habitus, control subjects were used to normalize BPA parameters for height to compute BPA Z-score equations.
Results
Between June 2007 and February 2010, BPA were recorded in 57 patients with KD >1 year after the onset of the disease, 45 without and 12 with coronary artery sequelae. The mean intervals between the acute onset of KD and enrollment were 10.0 卤 5.0 and 5.8 卤 4.5 years for patients with and without coronary artery sequelae, respectively (P聽= .008). Patients with KD with coronary artery sequelae had significantly altered Z聽scores of aortic diameter modulation, Peterson's elastic modulus, and 尾 stiffness index (P聽= .001-.016). Patients with KD without coronary artery sequelae also exhibited altered elasticity, stiffness, and pulse-wave velocity (P = .001鈭?026).
Conclusions
Altered BPA after KD are detectible despite apparent resolution of acute vasculitis. Future directions toward determining multilevel and multilayer vascular impact, including vascular autonomous homeostasis, require thorough investigation.