title: Impaired endothelial function in epicardial coronary arteries after Kawasaki disease.
abstract: BACKGROUND
  Intimal lesions observed in the coronary arteries (CAs) of patients who have suffered episodes of Kawasaki disease (KD) raise concern about the premature development of arteriosclerosis. Accordingly, we investigated endothelial function in the epicardial and resistance CAs after KD during long-term observation.
  
  
  RESULTS
  We assessed the responses of left epicardial and resistance CAs to serial intracoronary infusions of acetylcholine (final concentrations, 0.1 and 1 micromol/L) and nitroglycerin in subjects by using quantitative angiography and a Doppler flow wire system. Three age-matched groups were evaluated: 8 control subjects (group 1), 10 KD patients with normal left CA from the onset (group 2), and 8 KD patients with a persistent or regressed aneurysm in the left anterior descending CA (LAD) (group 3). Acetylcholine (1 micromol/L) changed the LAD area to 114.0+/-2.6%, 72.7+/-3.9% (P<.05 versus group 1), and 88.9+/-4.3% (P<.05 versus groups 1 and 2) of baseline in groups 1, 2, and 3, respectively, with a similar degree of increased coronary blood flow in each group. Nitroglycerin increased the LAD area to 143.5+/-7.7%, 132.3+/-1.9%, and 120.8+/-5.6% (P<.05 versus group 1), respectively.
  
  
  CONCLUSIONS
  Results demonstrate a persistent endothelial dysfunction in the epicardial but not resistance CAs in patients after KD and enhanced stiffness of persistent or regressed aneurysms. The concern over early arteriosclerosis warrants the surveillance of KD patients from childhood to adulthood.
authors.affiliation: Department of Pediatrics, Mie University School of Medicine, Tsu, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Mitani
authors.forename: Y
authors.initials: Y
authors.lastname: Okuda
authors.forename: H
authors.initials: H
authors.lastname: Shimpo
authors.forename: F
authors.initials: F
authors.lastname: Uchida
authors.forename: K
authors.initials: K
authors.lastname: Hamanaka
authors.forename: K
authors.initials: K
authors.lastname: Aoki
authors.forename: M
authors.initials: M
authors.lastname: Sakurai
mesh_terms: D000109:Acetylcholine / Q000008:administration & dosage; D002648:Child; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000503:physiopathology*; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D000109:Acetylcholine