title: Endothelial dysfunction in children within 5 years after onset of Kawasaki disease.
abstract: OBJECTIVE
  To evaluate endothelial function in children within 5 years after the onset of Kawasaki disease (KD).
  
  
  METHODS
  A total of 46 children were enrolled prospectively as follows: 9 patients with KD and coronary artery lesions composed group 1, 15 patients with KD but without coronary artery lesions composed group 2, and 22 healthy age- and sex-matched children composed group 3. Flow-mediated dilatation (FMD) of the brachial artery, intima-media thickness of the common carotid artery, and biologic characteristics were compared among the 3 groups. Differences in the factors associated with endothelial function after KD were examined as well.
  
  
  RESULTS
  The mean age of the study group was 6.5 ± 1.7 years. The patients with KD were studied at a median interval of 3.3 years (IQR, 2.0-4.4 years) from the onset of disease. The percent FMD (%FMD) was significantly lower in group 1 patients (median, 4.4%; IQR, 2.6%-5.7%) compared with both group 2 (median, 9.1%; IQR 6.6%-10.7%; P < .01) and group 3 (median, 11.1%; IQR, 10.1%-13.9%, P < .01). The %FMD was statistically significantly lower in group 2 compared with group 3 (P < .05). There were no significant differences in the intima-media thickness among the 3 groups. There was a significant negative correlation between %FMD and the total duration of fever (r = -0.50; P = .013).
  
  
  CONCLUSIONS
  The children with KD already had arterial endothelial dysfunction within 5 years after the onset of illness. The longer the duration of fever, the greater the risk of inflammation-induced endothelial dysfunction.
authors.affiliation: Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan. Electronic address: takamichinet@aol.com.
authors.forename: Takamichi
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Satoru
authors.initials: S
authors.lastname: Iwashima
mesh_terms: D017668:Age of Onset; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005334:Fever; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000175:diagnosis*; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D014652:Vascular Diseases / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology
keywords: %FMD; %GTN; C-reactive protein; CAL; CRP; Coronary artery lesion; ECG; Electrocardiography; FMD; Flow-mediated dilatation; GTN; Glyceryl trinitrate; HDL-C; High-density lipoprotein cholesterol; IMT; IVIG; Intima-media thickness; Intravenous immunoglobulin; KD; Kawasaki disease; LDL-C; Low-density lipoprotein cholesterol; Percent FMD; Percent GTN; TC; Total cholesterol