300 Endothelial function and arterial mechanical properties in children after Kawasaki disease

Abstract

Kawasaki disease is the leading cause of acquired heart disease in children. Increased cardiovascular risk can be assessed by intima-media thickness (IMT), a strong independent predictive factor for coronary heart disease, as could be the flow-mediated vasodilatation (FMD). However, controversy exists about these parameters if altered in children with Kawasaki disease. The aim of our study was to study the mechanical arterial properties and to analyze endothelial function by measuring the flow-mediated dilatation proving its alteration in Kawasaki disease patients evolving with moderate or without coronary artery lesions. A study design of 29 patients who had Kawasaki disease with no or transient or coronary artery involvement less than 4 mm of dilatation (group I), mean age 7,6 years, was compared to 30 healthy age-matched children (group II), mean age of 8,3 years. The carotid IMT, incremental elastic modulus, cross sectional compliance, distensibility and FMD were determined non-invasively one year following the disease. No significant difference was found with Flow-Mediated Dilatation between either group, for group I (9,16%, Standard Deviation: SD = 5,05) and group II (8,8%, SD = 4,56). As it was for mechanical arterial properties, like incremental elastic modulus, vascular compliance, distensibility and IMT, for group I (Mean IMT = 0,44 mm, SD = 0,028) vs (0,46 mm, SD = 0,060) for group II. Early evaluation of mechanical properties and endothelial function of the arteries in patients with Kawasaki disease, who have no or little dilatation less than 4 mm in coronary arteries, don’t show any alteration as compared with healthy population. However, this non-invasive test could be performed to a larger population of Kawasaki patients described above, in a prospective study with repeated measurements and follow up at different ages to confirm the absence of cardiovascular risk.