Abstract
Introduction: Recent studies have suggested that patients after Kawasaki disease (KD) have altered arterial stiffness. However, there is little evidence of the relationship between arterial stiffness and left ventricular (LV) global function of KD patients without cardiac ischemic region. Hypothesis: We hypothesized that the alteration in the elastic properties of the ascending aorta may influence both LV function. Methods: Sixty one patients after KD (age, 6.1±4.0 years) were studied, comprising 15patients with CAAs and 46 patients without CAA. All the patients with CAAs showed no cardiac ischemic region confirmed by myocardial perfusion SPECT. Using pulsed Doppler echocardiography combined with Doppler tissue imaging, mitral peak velocities during early diastole (E) and LV peak myocardial velocities during early diastole (e’) and systole (s’) were measured. The ratio of E/e’ was used as an index of filling pressure of the LV. From Doppler tissue imaging, Doppler-derived index of combined systolic/diastolic myocardial performance (Tei index) was calculated as a surrogate for LV global function. We also obtained aortic stiffness index (ASI), and aortic distensibility (AD) from the measurements of the ascending aorta with noninvasive evaluation of blood pressure. Results: In all the patients, febrile periods of acute stage of KD showed significantly positive correlation with ASI, and showed significantly negative correlation with AD (both p <0.05). E/e’ showed significantly positive correlations with ASI, pulse pressure and showed significantly negative correlations with s’, and AD (both p <0.05). The patients with CAAs showed significantly greater pulse pressure, LV Tei index and ASI than those without CAAs (all p <0.05). Conclusions: KD especially with CAAs showed subclinical abnormal LV performance that is related to altered central aortic elastic properties.
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