Relationship between carotid intima-media thickness and arterial stiffness in children after Kawasaki disease.
BACKGROUND
Evidence of premature atherosclerosis and systemic arterial stiffening in patients after Kawasaki disease is accumulating.


OBJECTIVE
To test the hypothesis that carotid intima-media thickness (IMT), a surrogate marker of atherosclerosis, is associated with systemic arterial stiffness in children after Kawasaki disease.


METHODS
A cohort of 72 patients was studied, comprising 26 patients with Kawasaki disease and coronary aneurysms (group I), 24 patients with Kawasaki disease and normal coronary arteries (group II) and 22 healthy age-matched children (group III). The carotid IMT, carotid artery stiffness index, brachioradial pulse wave velocity (PWV), fasting total cholesterol, high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol were determined and compared among the three groups.


RESULTS
The carotid IMT was related to indices of arterial stiffness, and significant determinants of carotid IMT were identified by multivariate analysis. The mean (standard deviation (SD)) carotid IMT of both group I (0.41 (0.04) mm) and group II (0.39 (0.04) mm) was significantly greater than that of group III (0.36 (0.04) mm; p<0.001 and p = 0.008, respectively). For the entire cohort, carotid IMT correlated positively with LDL cholesterol (r = 0.31, p = 0.009), carotid artery stiffness index (r = 0.40, p = 0.001) and brachioradial PWV (r = 0.28, p = 0.016), but not with age, body mass index, systemic blood pressure, and HDL and total cholesterol. Multiple linear regression analysis identified carotid artery stiffness index (beta = 0.25, p = 0.028) and subject grouping (beta = -0.39, p = 0.001; model R(2) = 0.29) as significant correlates of carotid IMT.


CONCLUSIONS
The increased carotid IMT in children after Kawasaki disease is associated with systemic arterial stiffening.
Cheung
Y-f
YF
Department of Paediatrics and Adolescent Medicine, Division of Paediatric Cardiology, Grantham Hospital, The University of Hong Kong, Hong Kong, China. xfcheung@hkucc.hku.hk
Wong
S J
SJ
Ho
M H K
MH
D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003323:Coronary Aneurysm / Q000097:blood / Q000503:physiopathology; D004548:Elasticity; D005260:Female; D006801:Humans; D008074:Lipoproteins / Q000097:blood; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood / Q000503:physiopathology*; D011673:Pulsatile Flow; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000503:physiopathology; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000503:physiopathology; D014463:Ultrasonography; D014655:Vascular Resistance / Q000502:physiology*
D008074:Lipoproteins