357 Imaging-Based Biomarkers: Quantification of Aortic Remodelling Following Kawasaki Disease

Abstract

BACKGROUND: It is known that Kawasaki disease (KD) causes generalized vasculitis, including the large arteries. However, current methods proposed to quantify KD-related vasculitis mainly investigate peripheral vascular function or use indirect measurements based on arterial geometry and blood flow. AIMS: Although those methods can be seen as observer-dependent, this work proposes a novel Imaging-based Biomarker (ImBioMark), a fully-developed automatic multiphysic model, to assess intrinsic mechanical features of the arterial wall. METHODS: The ascending aorta (AA) was examined. KD subjects diagnosed with coronary aneurysms (KDA, n 2) 13 1.41-year old, KD subjects diagnosed with coronary dilation (KDD, n 4) 8.67 4.65-year old and KD-free subjects (KDF, n 5) 10.80 2.62-year old were investigated. Bmode echocardiogrpahy video-sequences were digitally recorded with commercially available cardiac echocardiography machines. Strain within the AA wall was assessed with ImBioMark as a comparative measure of stiffness between subjects. RESULTS: KD with coronary aneurysms had a very significant impact on the AA stiffness. As illustrated in the figure below, KDA subjects’ aortic wall strain estimate was significantly lower compared to KDD and KDF (2.39 0.51% versus 4.65 0.72 and 4.24 0.65%, respectively; p 0.001). CONCLUSION: ImBioMark is a simple operator-independent technique proposed to quantify aortic wall remodelling following KD. These preliminary data tend to indicate a very significant increase in aortic stiffness for KDA subjects with respect to KDD and KDF. Such results underline the complexity that can be associated with KD pathophysiology and compel us to further investigate newly diagnosed KD patients in an observational prospective study with larger populations. HSF of Quebec