608 The Study of Late Arterial Lesion in Children with Coronary Aneurysm Due to Kawasaki Disease

Abstract

Objectives: Concerns have been raised regarding the existence of endothelial damage and the possibility of a predisposition to premature atherosclerosis in young adulthood with a history of Kawasaki disease (KD). This study was designed to evaluate the endothelial function and carotid intima-media thickness in children with coronary aneurysms. Methods: Thirty-one children with coronary aneurysms (9 with medium and 22 with giant aneurysms) due to KD and 21 healthy controls were enrolled. The duration from the onset of disease was 1-12.5 years (median 2.53 years) in KD group. Brachial artery flow-mediated dilation, non- flowmediated dilation, carotid artery stiffness index and intima-media thickness were determined by highfrequency ultrasound. Results: One KD patient had angina pectris, another had heart failure and abnormal Q waves. Endothelial dependent flow-mediated dilation (FMD) and Non flow-mediated dilation was lower in patients with coronary aneurysms due to KD as compared with normal controls (P< 0.05). Arterial stiffness index was raised in KD group than in normal controls (P< 0.05). There was no difference between the two groups in carotid intima-media thickness. The FMD was lower in KD patients with myocardial ischemia or ECG abnormalities than in patients without (P< 0.05), while no difference was found in FMD between patients with giant aneurysms and those with medium aneurysms. Conclusions: The endothelial function in patients with coronary aneurysms due to Kawasaki disease is damaged, especially in patients with giant coronary aneurysm and myocardial ischemia.