Endothelial dysfunction in adult patients with a history of Kawasaki disease.
To assess the existence of endothelial dysfunction and the possibility of the early onset of atherosclerosis in the chronic stage of Kawasaki disease (KD), we examined endothelial function in adult patients late after the onset of KD. We evaluated two age-matched groups: 35 adult KD patients (KD group) (mean age, 27.0 years; mean interval time, 24.1 years), and 36 healthy adults (control group). To assess vascular endothelial function, flow-mediated dilatation (%FMD) of the brachial artery and urinary nitrites and nitrates (NOx) were examined. We also measured adhesion molecules and several coagulation-fibrinolysis markers. In addition, we measured high-sensitive C-reactive protein (hs-CRP) as a chronic inflammatory marker, and brachial-ankle pulse wave velocity (baPWV) as a marker for arterial stiffness. %FMD was significantly reduced in the KD group when compared with that of the control group (KD group, 10.4 +/- 2.6%; control group, 14.4 +/- 3.2%, p<0.05), particularly in patients with coronary artery lesions. Thrombin-antithrombin III complex values were higher in the KD group, although no significant differences were observed in the other markers for endothelial function. Hs-CRP was significantly elevated only in the patients with coronary aneurysms. Furthermore, in the male KD patients, the baPWV values were significantly higher than those in the control subjects. This study revealed that the adult patients with a history of KD had systemic vascular endothelial dysfunction, and also suggested that a history of KD was possibly one of the risk factors for early onset of atherosclerosis.
Niboshi
Ayumi
A
Department of Pediatric Cardiology and Nephrology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan. ayu23@koto.kpu-m.ac.jp
Hamaoka
Kenji
K
Sakata
Koichi
K
Yamaguchi
Nozomi
N
D000328:Adult; D000704:Analysis of Variance; D000990:Antithrombin III; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000502:physiology; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D015815:Cell Adhesion Molecules / Q000097:blood; D002784:Cholesterol / Q000097:blood; D004548:Elasticity; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood / Q000503:physiopathology*; D010447:Peptide Hydrolases / Q000097:blood
D015415:Biomarkers; D015815:Cell Adhesion Molecules; C046193:antithrombin III-protease complex; D000990:Antithrombin III; D002097:C-Reactive Protein; D002784:Cholesterol; D010447:Peptide Hydrolases