title: The physiological significance of coronary aneurysms in Kawasaki disease.
abstract: OBJECTIVE
  A coronary aneurysm is one of the most frequent complications of Kawasaki disease, and yet there is little information concerning the haemodynamic abnormality influenced by the existence of a coronary aneurysm. When blood flow passes through an aneurysm, the turbulence that then occurs means that part of the initial energy is lost, and that energy loss could cause a drop in pressure, such as when passing through a stenotic lesion. The aim of this study is to prove the hypothesis that a giant aneurysm haemodynamically acts in a manner similar to that of stenosis.
  
  
  RESULTS
  The study population consisted of 47 patients with a simple coronary aneurysm after Kawasaki disease. Fractional flow reserve was measured in 32 coronary aneurysms. The fractional flow reserve in non-giant aneurysms was 0.95±0.03 and 0.90±0.03 in giant aneurysms (p=0.0004).
  
  
  CONCLUSIONS
  The present data demonstrated that the coronary aneurysm could give rise to a small decline of pressure along the artery. Since no aneurysm demonstrated a fractional flow reserve under 0.75, a simple aneurysm would not cause coronary ischaemia by itself. However, it could trigger a coronary ischaemia in case of multiple coronary aneurysms and a coronary aneurysm with mild stenosis.
authors.affiliation: Department of Pediatrics, Chiba Cardiovascular, Ichihara Center, Chiba, Japan. murat@seagreen.ocn.ne.jp
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Murakami
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tanaka
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006439:Hemodynamics; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000503:physiopathology*; D055815:Young Adult