Abstract
BackgroundKawasaki disease (KD) causes systemic vasculitis and coronary aneurysms. It frequently results in electrocardiographic (ECG) abnormalities of short duration. Cardiac sequelae persist beyond the acute stage in a few patients. There are many areas to be investigated concerning the effects on the vascular system of patients suffering from KD and its sequelae.MethodsThe cumulative incidences of KD and its cardiac sequelae were calculated in birth-year cohorts, using data obtained from KD nationwide surveys. The results were compared with the prevalence of ECG abnormalities detected in cardiac examinations conducted at primary and secondary schools for each birth-year cohort. This comparison allowed observation of relationships in these trends for each birth-year cohort.ResultsThe cumulative incidence of late-stage cardiac sequelae gradually declined. However, there were increases in the cumulative incidence of ECG abnormalities and in the cumulative incidences of KD and acute-stage cardiac disorders related to KD.ConclusionsThe results suggest that even among children without late cardiac sequelae, KD can have a persistent effect on the cardiovascular system. It thus appears necessary to extend clinical observation of children with a history of KD, even if they developed only acute-stage cardiac lesions.
Highlights
Since the first report on Kawasaki disease (KD), in 1967, there have been 19 nationwide surveys conducted in Japan from 1970 through 2006.1 These biennial retrospective incidence surveys investigated patients with KD who visited target hospitals for the first time
ECG abnormalities are not investigated in the nationwide surveys of KD, the surveys do request a list of patients who received a diagnosis of KD, together with their cardiac sequelae—such as coronary aneurysm, giant coronary aneurysm, coronary dilatation, coronary stenosis, valvular dysfunction, and myocardial infarctions
We examined the relationship between the cumulative incidence of KD in each birth-year cohort and the prevalence of abnormalities found during school cardiac examinations among these cohorts
Summary
Since the first report on Kawasaki disease (KD), in 1967, there have been 19 nationwide surveys conducted in Japan from 1970 through 2006.1 These biennial retrospective incidence surveys investigated patients with KD who visited target hospitals for the first time. From the early days of these surveys, vasculitis-related cardiac sequelae, such as coronary aneurysms, were noted, and electrocardiographic (ECG) abnormalities attracted attention. Kawasaki disease (KD) causes systemic vasculitis and coronary aneurysms It frequently results in electrocardiographic (ECG) abnormalities of short duration. The results were compared with the prevalence of ECG abnormalities detected in cardiac examinations conducted at primary and secondary schools for each birth-year cohort. This comparison allowed observation of relationships in these trends for each birth-year cohort. It appears necessary to extend clinical observation of children with a history of KD, even if they developed only acute-stage cardiac lesions
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