Abstract 174: Relationship between Kawasaki Disease Related-Angiopathy and Pressure Wave Reflection in the Arterial System

Abstract

Background: Recently we reported that the carotid arteries of Kawasaki disease (KD) appear to develop mild sclerotic changes shortly after onset using the speckle tracking echocardiography. However, it remains to be elucidated what factors hemodynamically may induce these sclerotic changes. Objectives: The aim of this study was to investigate the relationship between KD related-angiopathy and arterial pressure wave reflection using the two-dimensional speckle tracking echocardiography and radial augmentation index (AIx). Subjects & Methods: We studied a cohort of children with history of KD. The subjects were 87 KD patients (age, 9.7±2.9 years) and 93 healthy controls (11.3±3.2 years). As for our methodology, the two regions of interest (ROI) for speckle tracking were manually positioned at near and far carotid arterial walls using a Philips iE33. Continuously, we examined the following strain values: (A) peak strain in expansion phase, (B) peak strain before aortic valve closure, and (C) strain value at aortic valve closure (Figure 1). Also, we examined two ratios, B/A and C/A, for emphasizing recoil function. Concurrently, the radial AIx were obtained. Results: KD patients had significantly the lower A values, the higher B/A, and the higher radial AIx, compared with controls. Furthermore, there was good correlation between B/A and radial AIx in KD. Conclusions: It is well known that a higher AIx results from earlier arrival of reflected pressure waves and an early return of reflected waves is closely correlated with peripheral stiffness. Therefore, these results indicate that peripheral angiopathy may induce sclerotic changes of carotid arteries in KD patients.