Late Wall Thickening and Calcification in Patients After Kawasaki Disease

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• 作者：Nobuyuki Tsujii ; MD¹ ; ^{tsujiin@naramed-u.ac.jp} ; Etsuko Tsuda ; MD ; PhD¹ ; Suzu Kanzaki ; MD² ; Jun Ishizuka ; MD¹ ; Koichiro Nakashima ; MD¹ ; Kenichi Kurosaki ; MD¹
• 关键词：Kawasaki disease ; dual-source computed tomography ; computed tomography angiography ; coronary artery lesion ; coronary artery calcification
• 刊名：The Journal of Pediatrics
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：181
• 期：Complete
• 页码：167-171.e2
• 全文大小：1274 K
• 卷排序：181

文摘

To evaluate the relationship between the initial diameters of the coronary arteries immediately after the onset of Kawasaki disease (KD) and late increased coronary wall thickening/coronary artery calcification (CAC).Study DesignSixty-five patients (50 males and 15 females) who had undergone selective coronary angiography (CAG) <100 days after the onset of KD were studied late in disease by dual-source computed tomography (DSCT). The maximum diameters of each segment were measured in the initial CAGs, and the relationship between the maximum diameters and the appearance of increased wall thickening/CAC was analyzed. The study cohort was divided into 2 groups: the branches group (BG) and bifurcation at the left coronary artery (LCA) group. The cutoff point of acute coronary artery dilatation for increased wall thickening/CAC was calculated for each group. Risk factors for the appearance of CAC in each group were investigated, as was the sex difference related to the prevalence of CAC in coronary artery lesions (CALs) of the initial CAGs.ResultsThe cutoff points of acute coronary dilatation for increased wall thickening were 4.8 mm in the BG (n = 344; area under the curve [AUC], 0.89; P < .001) and 5.3 mm in the LCA group (n = 65; AUC, 0.87; P < .001). The interval from the onset of KD (P < .0001) and sex (P = .0084) were also related to the appearance of CAC in the BG.ConclusionAcute coronary dilatation of exceeding ~5.0 mm can lead to late abnormalities of the coronary artery wall. The prevalence of CAC increases with age. There was a sex-based difference in the late incidence of CAC in the CALs.