Abstract
Objective To investigate the correlation between carotid intima-media thickness (IMT), ankle-brachial index (ABI), and coronary artery dilatation (CAD) in children with Kawasaki disease (KD) and to evaluate the effectiveness of CAD. Methods A total of 68 children diagnosed with KD from January 2019 to January 2021 in our hospital were included. According to the results of cardiac color Doppler ultrasound, the children with KD were divided into a noncoronary artery dilation group (NCAD), with 41 children with KD who did not have coronary artery lesions, and a coronary artery dilation group (CAD), with 27 children with KD who had coronary artery dilation. 27 healthy children undergoing physical examination in our hospital at the same time were selected as the normal control group. Laboratory index of all subjects was measured individually. The carotid IMT, ABI, and coronary artery diameter of all subjects were measured and compared. Pearson correlation was used to analyze the correlation between carotid IMT, ABI, and the severity of coronary artery disease. The ROC curve was used to evaluate the efficacy of carotid IMT and ABI in predicting coronary artery disease. Results The ALB of children in the CAD group was lower than that in the NCAD group (P < 0.05). The IMT of carotid artery and the diameter of coronary artery in children of the CAD group and the NCAD group were higher than those of the normal control group, and the IMT of the CAD group was higher than that of the NCAD group. The ABI of children in the CAD group and the NCAD group was lower than that of the normal control group, and the ABI of children in the CAD group was lower than that of the NCAD group (P < 0.05). Correlation analysis showed that carotid artery IMT of children with KD was positively correlated with coronary artery diameter, while ABI was negatively correlated with coronary artery diameter. The AUC of carotid IMT for CAD in children with KD was 0.668 (95% CI: 0.538–0.797), that of ABI for CAD in children with KD was 0.646 (95% CI: 0.513–0.780), and that of the combination of carotid IMT and ABI for CAD was 0.874 (95% CI: 0.785–0.963). Conclusion The changes of carotid artery IMT and ABI in children with KD have a certain correlation with CAD, and the joint detection of carotid artery IMT and ABI can provide clinical reference value for predicting the degree of coronary artery disease in children with KD.
Highlights
Kawasaki disease (KD) is a skin mucosal lymph node syndrome, which is an acute febrile eruption disease of infants with systemic vasculitis as the main pathological change
The pathogenesis of KD is not very clear, and it is generally accepted that under the background of certain genetic predisposing factors, many pathogens enter children through the respiratory tract or other ways, which leads to the activation of immune-activated cells in children, the imbalance of immunity in children, and the release of a large number of inflammatory mediators, triggering children’s systemic vasculitis, especially the most prominent coronary artery [13]
It has been reported that acute inflammation caused by immune regulation disorder and infection is the key factor of KD complicated with coronary artery dilatation (CAD), but the specific regulatory factors and mechanisms are not clear [14]
Summary
Kawasaki disease (KD) is a skin mucosal lymph node syndrome, which is an acute febrile eruption disease of infants with systemic vasculitis as the main pathological change. It belongs to immunodamaging vasculitis and has the characteristics of high activation of immune system at the same time, making it prone to occur in children under 5 years of age [1, 2]. Even if high-dose gamma globulin is used in the early stage of the disease, about 5% of Kawasaki disease children will still have coronary artery dilatation and even further develop into coronary artery aneurysm [3]. KD has become the main cause of acquired heart disease in children in China [4]. erefore, the early
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