Coronary Normograms and the Coronary-Aorta Index: Objective Determinants of Coronary Artery Dilatation

2003 ◽  
Vol 24 (4) ◽  
pp. 328-335 ◽  
Author(s):  
T. H. Tan ◽  
K. Y. Wong ◽  
T. K. Cheng ◽  
J. T. Heng
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Dilatation

scholarly journals Clinical analysis of chronic active EBV infection with coronary artery dilatation and a matched case–control study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ang Wei ◽  
Honghao Ma ◽  
Liping Zhang ◽  
Zhigang Li ◽  
Yitong Guan ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Serum Ferritin ◽  
Epstein Barr Virus ◽  
Epstein Barr Virus Infection ◽  
Hematopoietic Stem ◽  
Barr Virus ◽  
Coronary Artery Dilatation ◽  
Tnf Α ◽  
Epstein Barr

Abstract Objective To investigate the clinical characteristics, treatment, prognosis and risk factors for chronic active Epstein–Barr Virus infection (CAEBV) associated with coronary artery dilatation (CAD) in children. Methods Children with CAEBV associated with CAD hospitalized at Beijing Children’s Hospital, Capital Medical University from March 2016 to December 2019 were analyzed. Children with CAEBV without CAD were selected as the control group and matched by sex, age, treatment and admission time. The clinical manifestations, laboratory and ultrasound examinations, treatment and prognosis of the children were collected in both groups. Results There were 10 children with CAEBV combined with CAD, including 6 males and 4 females, accounting for 8.9% (10/112) of CAEBV patients in the same period, with an onset age of 6.05 (2.8–14.3) years. The median follow-up time was 20 (6–48) months. All the patients had high copies of EBV-DNA in whole blood [1.18 × 107 (1.90 × 105–3.96 × 107) copies/mL] and plasma [1.81 × 104 (1.54 × 103–1.76 × 106) copies/mL], and all biopsy samples (bone marrow, lymph nodes or liver) were all positive for Epstein–Barr virus-encoded small RNA. Among the 10 children, 8 had bilateral CAD, and 2 patients had unilateral CAD. After diagnosis, 7 children were treated with L-DEP chemotherapy in our hospital. After chemotherapy, four patients underwent allogeneic hematopoietic stem cell transplantation (HSCT). The others were waiting for HSCT. At the time of the last patients follow up record, the CAD had returned to normal in 3 patients, and the time from the diagnosis of CAD to recovery was 21 (18–68) days. LDH, serum ferritin, TNF-α and IL-10 levels were statistically significantly different between the two groups (P = 0.009, 0.008, 0.026 and 0.030). There were no significant differences in survival rate between the two groups (P = 0.416). Conclusion The incidence of CAEBV with CAD was low. CAEBV with CAD did not influence the prognosis. Patients who had high LDH, serum ferritin, TNF-α, and IL-10 levels early in their illness were more likely to develop CAD.

Abstract O.53: Occult Coronary Artery Dilatation: An Unrecognized Category Of Coronary Involvement

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Soha Rached-d'Astous ◽  
Nour Rached-d'Astous ◽  
Frederic Dallaire ◽  
Nagib Dahdah
Keyword(s):  
Coronary Artery ◽  
Linear Equations ◽  
Young Patients ◽  
Treatment Resistance ◽  
Trend Test ◽  
Ivig Treatment ◽  
Z Score ◽  
Inflammatory Parameters ◽  
Coronary Artery Dilatation ◽  
Significant Difference

Background: The current definition of Coronary artery dilatation (CAD), Z-score >2.5, in KD may omit patients at higher risk of later complications. We propose a category of occult CAD with a Z-score variation ≥ 2 for the same CA on 2 different echocardiograms, but absolute Z-score < 2.5. We compared this new category with cases of CAD and normal CA. >Method: A retrospective review included 337 patients diagnosed with KD in our institution. Echographic data were retrieved for the fist year following diagnosis. Patients were classified in three categories: definite CA dilatation (dCAD) with Z-score ≥ 2.5, occult CA dilatation (oCAD) and normal CA (nCA). We compared inflammatory profile, IVIG treatment resistance, and timing of CA involvement. Results: There were 26.3% patients with nCA, 32.2% with oCAD and 41.1% with dCAD.Patients with KD incomplete diagnostic criteria represented 35%, 14% and 17% for NCAD, OCAD and DCAD groups respectively (p=0.008). Median time for CAD was 7 and 9.5 days for dCAD and oCAD respectively (p=0.2). A Jonckheere trend test identified a progression of inflammatory parameters through the three groups for Platelet count (p< 0.001), Albumin (p = 0.007), ESR (p = 0.04), but not for CRP (p = 0.76) and WBC (p = 0.16). There was a significant difference in treatment resistance, with 5%, 19% and 31% for NCAD, OCAD and DCAD respectively (p=0,002). Conclusion: OCAD group appears like a distinctive subgroup of KD patients showing intermediate inflammatory profiles and treatment respond in the NCAD to DCAD spectrum. Recent Z-score equations, more accurate for young patients’ CA size than former linear equations, may explain the high incidence of dCAD in this report. Further studies are needed to define the profile and propensity to complications of this subpopulation.

Kawasaki Disease in a Patient With Williams Syndrome

2018 ◽  
Vol 11 (4) ◽  
pp. NP144-NP147
Author(s):  
Aleisha M. Nabower ◽  
Lois J. Starr ◽  
Jonathan Cramer
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Williams Syndrome ◽  
Coronary Arteries ◽  
Incomplete Kawasaki Disease ◽  
Cardiac Anomalies ◽  
Coronary Artery Dilatation ◽  
Coronary Aneurysms

Kawasaki disease can be difficult to diagnose in infants, putting them at higher risk for developing coronary artery dilatation. It can be even more difficult to diagnose in the setting of preexisting cardiac anomalies such as those found in Williams syndrome. We present a case of a three-month-old male with Williams syndrome with rapidly developing giant coronary aneurysms due to Kawasaki disease. This case demonstrates the importance of repeat echocardiography in diagnosing incomplete Kawasaki disease in infants. We speculate that elastin changes, as present in Williams syndrome, may put affected children at higher risk for development of giant coronary arteries should they acquire Kawasaki disease.

scholarly journals Relationship between ocular involvement and clinical manifestations, laboratory findings, and coronary artery dilatation in Kawasaki disease

Eye ◽  
2020 ◽  
Vol 34 (10) ◽  
pp. 1883-1887 ◽  
Author(s):  
Reza Shiari ◽  
Mohsen Jari ◽  
Saeed Karimi ◽  
Omid Salehpour ◽  
Khosro Rahmani ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Clinical Manifestations ◽  
Ocular Involvement ◽  
Laboratory Findings ◽  
Coronary Artery Dilatation

Q Fever and Kawasaki Disease with Coronary Artery Dilatation

2016 ◽  
Vol 11 (02) ◽  
pp. 051-052
Author(s):  
Jolanta Bernatoniene ◽  
Gareth Morgan ◽  
Paul Heaton
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Q Fever ◽  
Coronary Artery Dilatation

Coronary Artery Dilatation and Aortic Outflow Tract Enlargement in Children with Unicommissural Aortic Valves

2004 ◽  
Vol 26 (4) ◽  
pp. 408-412
Author(s):  
M.J. Faber ◽  
J.S. Zeiger ◽  
P.J. Spevak ◽  
J.I. Brenner ◽  
W.J. Ravekes
Keyword(s):  
Coronary Artery ◽  
Outflow Tract ◽  
Aortic Valves ◽  
Coronary Artery Dilatation

Coronary artery dilatation and vasculitis in a case of rabies: Similarity with Kawasaki disease?

2013 ◽  
Vol 55 (2) ◽  
pp. 237-240 ◽  
Author(s):  
Ibtissama Boukas ◽  
Nagib Dahdah ◽  
Yves Robitaille ◽  
Anne Fournier
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Artery Dilatation

scholarly journals 1025. Prediction of Intravenous Immunoglobulin Resistance and Coronary Artery Dilatation in Kawasaki Disease: a Multicenter Study from Oman

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S604-S604
Author(s):  
Fatma Al Mwaiti ◽  
Zaid Alhinai ◽  
Safiya AlAbrawi ◽  
Asmhan A L mamari ◽  
Reem Abdwani ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Coronary Artery ◽  
High Risk ◽  
Kawasaki Disease ◽  
Disease Severity ◽  
Primary Outcome ◽  
Male Gender ◽  
Ivig Resistance ◽  
Coronary Artery Dilatation

Abstract Background Prediction of intravenous immunoglobulin (IVIG) resistance and coronary artery dilatation continues to be a challenge in the management of Kawasaki disease. Significant differences exist among different populations. Methods Children &lt; 13 years of age who presented to the two main tertiary care hospitals in Oman (Royal Hospital and Sultan Qaboos University Hospital) between 2008 and 2019 with a diagnosis of Kawasaki disease were included. Diagnosis was confirmed and clinical, laboratory and echocardiography data was systematically collected and checked for accuracy. The primary outcome was the presence of IVIG resistance or coronary artery dilatation at the 6-week follow-up. Bivariate analysis was used to identify significant predictors of the primary outcome, followed by multivariable logistic regression to determine independent predictors. The Muscat Index of Kawasaki disease Severity (MIKS) score was created based on the results. Results 156 children with Kawasaki disease were included. Median age was 2.1 years (IQR 0.9-3.8), and 64% were males. All patients received IVIG, 26 (17%) received steroids, and one received infliximab. Coronary dilatation was identified in 41 (26%) patients on initial echocardiogram, and 26 (18%) at the 6-week follow-up visit. Variables significantly associated with the primary outcome were age ≤15 months (P=0.031), hemoglobin (P=0.009), WBC count (P=0.002), absolute neutrophil count (P=0.006), and CRP ≥150 mg/L (P=0.015). These variables in addition male gender (P=0.058), ALT &gt;80 IU/L (P=0.10) and serum sodium (P=0.10), were entered into multivariable logistic regression. A predictive model based on CRP ≥150 mg/L (LR=2.2, P=0.049), male gender (LR=2.1, P=0.095) and WBC (LR=1.1, P=0.017) resulted, and it was used as basis for the MIKS score (Table 1). The MIKS score performed favorably to the Kobayashi score in its sensitivity to predict the primary outcome and its separate components (Table 2). Combining the MIKS score with other high-risk criteria had a sensitivity of 95% in predicting the primary outcome and a specificity of 56%. Table 1. Calculation of the Muscat Index of Kawasaki disease Severity (MIKS) score Table 2. Sensitivity, specificity and P value for the Kobayashi, MIKS, and combined high risk criteria in predicting IVIG resistance, coronary dilatation at 6 weeks, separately or in combination, among patients with Kawasaki disease. MIKS: Muscat Index of Kawasaki disease Severity. *High risk: presence of coronary artery dilatation on initial echocardiogram or age &lt;1&gt; Conclusion The MIKS score predicts IVIG resistance and coronary artery dilatation in Kawasaki disease in our setting, with favorable performance compared to the Kobayashi score. Disclosures All Authors: No reported disclosures

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