title: Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT).
abstract: BACKGROUND
  Coronary artery aneurysms (CAA) are serious complications of Kawasaki disease (KD). Optical coherence tomography (OCT) is a high-resolution intracoronary imaging modality that characterizes coronary artery wall structure. The purpose of this work was to describe CAA wall sequelae after KD.
  
  
  RESULTS
  KD patients scheduled for routine coronary angiography underwent OCT imaging between March 2013 and August 2014. Subjects' clinical courses, echocardiography, and coronary angiography examinations were reviewed retrospectively. OCT was performed in 18 patients aged 12.4±5.5 years, 9.0±5.1 years following onset of KD. Of those, 14 patients (77.7%) had a history of CAA (7 with giant CAA and 7 with regressed CAA at time of OCT). Intracoronary nitroglycerin was given to all patients (88.4±45.5 μg/m(2)). Mean radiation dose was 10.9±5.2 mGy/kg. One patient suffered from a transitory uneventful vasospasm at the site of a regressed CAA; otherwise no major procedural complications occurred. The most frequent abnormality observed on OCT was intimal hyperplasia (15 patients, 83.3%) seen at both aneurysmal sites and angiographically normal segments amounting to 390.8±166.0 μm for affected segments compared to 61.7±17 μm for unaffected segments (P<0.001). Disappearance of the media, and presence of fibrosis, calcifications, macrophage accumulation, neovascularization, and white thrombi were seen in 72.2%, 77.8%, 27.8%, 44.4%, and 33.3% of patients.
  
  
  CONCLUSIONS
  In this study, OCT proved safe and insightful in the setting of KD, with the potential to add diagnostic value in the assessment of coronary abnormalities in KD. The depicted coronary structural changes correspond to histological findings previously described in KD.
authors.affiliation: Division of Pediatric Cardiology, CHU Sainte-Justine, Montreal, Quebec, Canada (A.D., R.I., M.B., J.B.S., M.L., P.G., A.F., N.D.).
authors.forename: Audrey
authors.initials: A
authors.lastname: Dionne
authors.affiliation: Division of Pediatric Cardiology, CHU Sainte-Justine, Montreal, Quebec, Canada (A.D., R.I., M.B., J.B.S., M.L., P.G., A.F., N.D.) Division of Cardiology, Pierre Boucher Hospital, Longueuil, Quebec, Canada (R.I.).
authors.forename: Ragui
authors.initials: R
authors.lastname: Ibrahim
authors.affiliation: Division of Cardiology, Montreal Heart Institute, Montreal, Quebec, Canada (C.G.).
authors.forename: Catherine
authors.initials: C
authors.lastname: Gebhard
authors.affiliation: Division of Pediatric Cardiology, CHU Sainte-Justine, Montreal, Quebec, Canada (A.D., R.I., M.B., J.B.S., M.L., P.G., A.F., N.D.) Division of Pediatric Cardiology, Louis Pradel Hospital, Lyon, France (M.B.).
authors.forename: Mohamed
authors.initials: M
authors.lastname: Bakloul
authors.affiliation: Division of Pediatric Cardiology, CHU Sainte-Justine, Montreal, Quebec, Canada (A.D., R.I., M.B., J.B.S., M.L., P.G., A.F., N.D.) Division of Pediatric Cardiology, CHU Bordeaux, Pessac, France (J.B.S.).
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Selly
authors.affiliation: Division of Pediatric Cardiology, CHU Sainte-Justine, Montreal, Quebec, Canada (A.D., R.I., M.B., J.B.S., M.L., P.G., A.F., N.D.).
authors.forename: Mohamed
authors.initials: M
authors.lastname: Leye
authors.affiliation: Division of Radiology, CHU Ste-Justine, Montreal, Quebec, Canada (J., C.L.).
authors.forename: Julie
authors.initials: J
authors.lastname: Déry
authors.affiliation: Division of Radiology, CHU Ste-Justine, Montreal, Quebec, Canada (J., C.L.).
authors.forename: Chantale
authors.initials: C
authors.lastname: Lapierre
authors.affiliation: Division of Pediatric Cardiology, CHU Sainte-Justine, Montreal, Quebec, Canada (A.D., R.I., M.B., J.B.S., M.L., P.G., A.F., N.D.).
authors.forename: Patrice
authors.initials: P
authors.lastname: Girard
authors.affiliation: Division of Pediatric Cardiology, CHU Sainte-Justine, Montreal, Quebec, Canada (A.D., R.I., M.B., J.B.S., M.L., P.G., A.F., N.D.).
authors.forename: Anne
authors.initials: A
authors.lastname: Fournier
authors.affiliation: Division of Pediatric Cardiology, CHU Sainte-Justine, Montreal, Quebec, Canada (A.D., R.I., M.B., J.B.S., M.L., P.G., A.F., N.D.).
authors.forename: Nagib
authors.initials: N
authors.lastname: Dahdah
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000175:diagnosis* / Q000209:etiology*; D017023:Coronary Angiography / Q000379:methods; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D005996:Nitroglycerin / Q000008:administration & dosage; D041623:Tomography, Optical Coherence / Q000379:methods*; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin
keywords: coronary disease; imaging; pediatrics