title: Arterial stiffness in patients after Kawasaki disease without coronary artery involvement: Assessment by performing brachial ankle pulse wave velocity and cardio-ankle vascular index.
abstract: BACKGROUND
  It remains unclear whether systemic arterial beds other than the coronary arteries are truly healthy in patients without coronary artery lesions (CAL) after Kawasaki disease (KD). We tested the hypothesis that patients with KD without echocardiographic evidence of CAL during the acute phase of the disease have abnormal mechanical properties in systemic arteries later.
  
  
  RESULTS
  We studied 201 consecutive patients with KD (age 2-23 years, mean 10±4 years; 109 male, 92 female) without CAL during the acute phase. Data were compared with those in 129 control subjects (age 2-25 years, mean 10±4 years; 73 male, 56 female; control group). We examined arterial stiffness by using the brachial-ankle pulse wave velocity (baPWV) and the cardio-ankle vascular index (CAVI). The baPWV in the KD group was significantly higher than that in the control group (913±121cm/s vs. 886±135cm/s, p=0.04). In contrast, there was no significant difference in CAVI (4.0±1.0 vs. 4.2±1.0, p=0.9) between the two groups. Multivariate analysis indicated a highly significant difference in baPWV (higher baPWV in patients with KD than in controls, p=0.004), after controlling for age, gender, body height and weight, and systolic and diastolic blood pressure, but no difference in CAVI between the groups.
  
  
  CONCLUSIONS
  Years after KD occurs in patients without apparent CAL during the acute phase, there is a small but significant change in systemic arterial properties, characterized by increased wall stiffness. The clinical importance of these findings must be clarified by performing long-term follow-up studies.
authors.affiliation: Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Nakagawa
authors.affiliation: Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Kuwata
authors.affiliation: Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Clara
authors.initials: C
authors.lastname: Kurishima
authors.affiliation: Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Saiki
authors.affiliation: Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Iwamoto
authors.affiliation: Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Sugimoto
authors.affiliation: Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Ishido
authors.affiliation: Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Masutani
authors.affiliation: Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan. Electronic address: hsenzaki@saitama-med.ac.jp.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Senzaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000842:Ankle / Q000098:blood supply*; D055109:Ankle Brachial Index; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000503:physiopathology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003331:Coronary Vessels / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000503:physiopathology*; D011673:Pulsatile Flow; D059289:Vascular Stiffness; D055815:Young Adult
keywords: Arterial stiffness; Cardio-ankle vascular index; Kawasaki disease; Pulse wave velocity