title: Vascular health in Kawasaki disease.
abstract: OBJECTIVE
  The objective of our study was to compare the indices of vascular health in Kawasaki disease (KD) patients to those of control subjects.
  
  
  BACKGROUND
  The literature on peripheral vascular health after KD is conflicting.
  
  
  METHODS
  Subjects were patients 11 to 29 years of age with the onset of KD >12 months before the study visit (n = 203) and healthy control subjects (n = 50). We measured endothelial function (using the Endothelial Pulse Amplitude Testing index), intima-media thickness (IMT) of the right common carotid artery (RCCA) and the left common carotid artery (LCCA), and fasting lipid profile and C-reactive protein (CRP). KD patients were classified according to their worst-ever coronary artery (CA) status: group I, always normal CAs (n = 136, 67%); group II, CA z-scores ≥2 but <3 (n = 20, 10%); group III, CA aneurysm z-scores ≥3 but <8 mm (n = 40, 20%); and group IV, giant CA aneurysm, defined as ≥8 mm (n = 7, 3%).
  
  
  RESULTS
  At a median of 11.6 years (range, 1.2 to 26 years) after KD onset, compared with controls, KD patients had a higher peak velocity in the LCCA (p = 0.04) and higher pulsatility index of both the RCCA and LCCA (p = 0.006 and p = 0.05, respectively). However, there were no differences in the Endo-PAT index or carotid IMT or stiffness. The mean IMT of the LCCA tended to differ across the KD subgroups and control group (p = 0.05), with a higher mean in group IV. Otherwise the KD subgroups and control group had similar vascular health indexes.
  
  
  CONCLUSIONS
  In contrast to some earlier reports, our study of North American children and young adults demonstrated that KD patients whose maximum CA dimensions were either always normal or mildly ectatic have normal vascular health indexes, providing reassurance regarding peripheral vascular health in this population.
authors.affiliation: Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Pediatric Cardiology, Department of Pediatrics, Stanford University, Stanford, California. Electronic address: tierneys@stanford.edu.
authors.forename: Elif Seda
authors.initials: ES
authors.lastname: Selamet Tierney
authors.affiliation: Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Dana
authors.initials: D
authors.lastname: Gal
authors.affiliation: Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Gauvreau
authors.affiliation: Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Annette L
authors.initials: AL
authors.lastname: Baker
authors.affiliation: Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Shari
authors.initials: S
authors.lastname: Trevey
authors.affiliation: Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: O'Neill
authors.affiliation: Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Jaff
authors.affiliation: Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Sarah
authors.initials: S
authors.lastname: de Ferranti
authors.affiliation: Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: David R
authors.initials: DR
authors.lastname: Fulton
authors.affiliation: Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Colan
authors.affiliation: Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jane W
authors.initials: JW
authors.lastname: Newburger
mesh_terms: D000293:Adolescent; D000328:Adult; D001900:Boston / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D014463:Ultrasonography; D055815:Young Adult
keywords: C-reactive protein; CA; CCA; CRP; Endo-PAT; Endothelial Pulse Amplitude Testing; IMT; KD; Kawasaki; Kawasaki disease; LCCA; RCCA; atherosclerosis; common carotid artery; coronary artery; coronary artery aneurysm; endothelial function; intima-media thickness; left common carotid artery; right common carotid artery; vascular health