title: Long-term evaluation of endothelial function in Kawasaki disease patients.
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.
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal.
authors.forename: Fátima F
authors.initials: FF
authors.lastname: Pinto
authors.forename: Sérgio
authors.initials: S
authors.lastname: Laranjo
authors.forename: Filipa
authors.initials: F
authors.lastname: Paramés
authors.forename: Isabel
authors.initials: I
authors.lastname: Freitas
authors.forename: Miguel
authors.initials: M
authors.lastname: Mota-Carmo
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D008297:Male; D008365:Manometry; D055806:Microvessels / Q000503:physiopathology*; D009080:Mucocutaneous Lymph Node Syndrome / Q000503:physiopathology*; D063177:Pulse Wave Analysis; D055815:Young Adult