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Long-term evaluation of endothelial function in Kawasaki disease patients

Published online by Cambridge University Press:  08 October 2012

Fátima F. Pinto ,
Sérgio Laranjo ,
Filipa Paramés ,
Isabel Freitas  and
Miguel Mota-Carmo
Fátima F. Pinto*
Affiliation:
Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal
Sérgio Laranjo
Affiliation:
Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal
Filipa Paramés
Affiliation:
Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal
Isabel Freitas
Affiliation:
Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal
Miguel Mota-Carmo
Affiliation:
Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal
*
Correspondence to: Fátima F. Pinto, MD, Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Rua de Santa Marta, 1169-024 Lisboa, Portugal. Tel: +213594332; Fax: +213594034; E-mail: [email protected]
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Abstract

Background

Kawasaki disease is an acute systemic vasculitis. Cardiac complications are frequent and include endothelial dysfunction in patients with coronary anomalies. So far, the presence of endothelial dysfunction in patients with no coronary lesions has not been demonstrated. Peripheral arterial tonometry (Endo-PAT) measures the microvascular function in response to local ischaemia and has been validated in adult population, but its use in children is scarce.

Aim

To evaluate endothelial dysfunction in children as a long-term complication after Kawasaki disease using Endo-PAT.

Methods

We evaluated two groups of subjects: (1) Kawasaki disease patients over 11 years of age, diagnosed for >5 years, with no coronary lesions, or any other risk factors for cardiovascular disease; (2) control group of individuals without cardiovascular risk factors. Patients and controls were clinically accessed. Endo-PAT was performed to determine reactive hyperaemia index and augmentation index.

Results

A total of 35 individuals (21 males, age 21 ± 6 years) were evaluated (group 1: 19; controls: 16). Kawasaki disease patients presented significant lower reactive hyperaemia index (1.68 ± 0.49 versus 2.31 ± 0.53; p = 0.001). Augmentation index was similar in both groups (−10 ± 7 versus −11 ± 5; p > 0.005). Most patients with Kawasaki disease disclosed endothelial dysfunction (68%) compared with only 12% in controls.

Conclusions

Endo-PAT is feasible and reproducible in the child population. Endothelial dysfunction is a frequent long-term complication in patients after Kawasaki disease with normal appearing coronary arteries. However, these results need validation in a larger population.

Keywords

Kawasaki diseaseendothelial functionEndo-PAT
Type
Original Articles
Information
Cardiology in the Young , Volume 23 , Issue 4 , August 2013 , pp. 517 - 522
Copyright
Copyright © Cambridge University Press 2012 

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