Abstract 74: Coronary Artery Lesions in Children with Kawasaki’s Disease: A 10-Year Follow-up in Moscow

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Olga Bockeria ◽  
Galina Lyskina ◽  
Olga Shirinskaya ◽  
Anna Satyukova ◽  
Nina Gagarina
Keyword(s):  
Coronary Angiography ◽  
Coronary Arteries ◽  
Systemic Vasculitis ◽  
Coronary Arteriography ◽  
Acute Stage ◽  
Contrast Study ◽  
Giant Aneurysms ◽  
Kawasaki’S Disease ◽  
Kawasaki's Disease

Background: Kawasaki’s disease (KD) is an acute systemic vasculitis in childhood. Lesion in the coronary arteries (CA) causes an acute or chronic ischemia, myocardial infarction and sudden death. Materials and Methods: The study included 189 children with KD for the period of 9 years (2004 - 2013). The age of the patients at the time of the acute stage of the disease was 1 month - 12 years 8 months . Boys and girls ratio was 1.8:1. 92% of the children were ill at the age of up to 5 years. Mean follow-up period was 15,8 months. We performed coronary angiography by CT scan in 14 children and by catheter in 9 children in CCVS. Echo was done in all 189 children. Results: Aneurysms of CA were found in 59 (31.2%) patients according to echocardiography data. The frequency of aneurysm formation in children first year of life was higher than in children older than 1 year (41.3% and 29.3%). Thirty eight (20%) patients had multiple aneurysms. Small aneurysms with a diameter less than 5 mm were found in 16.4% of patients, average (5 - 8 mm) - in 9%, giant (greater than 8 mm) - in 5.8% of patients. Transient CA ectasia was diagnosed in 13.2% of children. Sensitivity of echocardiography in diagnosis of CA aneurysms was 88.5% in comparison with MSCT coronary angiography, specificity - 92.3%. Mean aneurysms' diameter measured by ECHO was 7,1 ± 3,3 mm, while CT contrast study revealed 7,3 ± 3,1 mm (p> 0.05). We found an involution of 40.2% of aneurysms during follow-up. Thrombi were found in 8 of 11 patients with giant aneurysms by echocardiography. Five thrombi disappeared after conservative therapy, 2 increased and occluded the RCA. CA stenosis greater than 75% was revealed in 2 patients with giant aneurysms in 2 years 7 months and in 3.5 months after manifestation of KD by using coronary arteriography. Conclusion: Kawasaki’s disease is a frequent cause of aneurysms, thrombosis and stenosis in coronary arteries in early childhood. Giant aneurysms often predispose to occlusion of the CA. Echocardiography is a highly specific and sensitive method for the visualization of CA aneurysms and thrombi. Other methods are useful when distinguishing stenosis and thrombosis in small CA is required.

scholarly journals Endothelial dysfunction as predictor of angina recurrence after successful percutaneous coronary intervention using second generation drug eluting stents

2018 ◽  
Vol 25 (13) ◽  
pp. 1360-1370 ◽  
Author(s):  
Rocco A Montone ◽  
Giampaolo Niccoli ◽  
Federico Vergni ◽  
Vincenzo Vetrugno ◽  
Michele Russo ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Endothelial Dysfunction ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Percutaneous Coronary ◽  
Drug Eluting

Background The role of endothelial dysfunction in predicting angina recurrence after percutaneous coronary intervention is unknown. Design We assessed the role of peripheral endothelial dysfunction measured by reactive-hyperaemia peripheral-artery tonometry (RH-PAT) in predicting recurrence of angina after percutaneous coronary intervention. Methods We enrolled consecutive patients undergoing percutaneous coronary intervention with second-generation drug-eluting stents. RH-PAT was measured at discharge. The endpoint was repeated coronary angiography for angina recurrence and/or evidence of myocardial ischaemia at follow-up. Patients with in-stent restenosis and/or significant de novo stenosis were defined as having angina with obstructed coronary arteries (AOCA); all other patients as having angina with non-obstructed coronary arteries (ANOCA). Results Among 100 patients (mean age 66.7 ± 10.4 years, 80 (80.0%) male, median follow-up 16 (3–20) months), AOCA occurred in 14 patients (14%), ANOCA in nine patients (9%). Repeated coronary angiography occurred more frequently among patients in the lower RH-PAT index tertile compared with middle and upper tertiles (14 (41.2%) vs. 6 (18.2%) vs. 3 (9.1%), p = 0.006, respectively). ANOCA was more frequent in the lower RH-PAT index tertile compared with middle and upper tertiles. In the multivariate regression analysis, the RH-PAT index only predicted angina recurrence. The receiver operating characteristic curve of the RH-PAT index to predict the angina recurrence demonstrated an area under the curve of 0.79 (95% confidence interval: 0.69–0.89; p < 0.001), with a cut-off value of 1.705, having sensitivity 74% and specificity 70%. Conclusions Non-invasive assessment of peripheral endothelial dysfunction using RH-PAT might help in the prediction of recurrent angina after percutaneous coronary intervention, thus identifying patients who may need more intense pharmacological treatment and risk factor control.

Kawasaki's Disease in Remission With Cardiac Involvement: Intrasacular Thrombus in a Giant Aneurism of Both Coronary Arteries. Case Report

2011 ◽  
Vol 7 (5) ◽  
pp. 329-332
Author(s):  
Karla Mendiola Ramírez ◽  
Jorge Omar Osorio Díaz ◽  
María del Rocío Maldonado Velázquez ◽  
Enrique Faugier Fuentes
Keyword(s):  
Case Report ◽  
Coronary Arteries ◽  
Cardiac Involvement ◽  
Kawasaki’S Disease ◽  
Kawasaki's Disease

Long-Term Follow-Up with Stress Echocardiograms of Patients with Kawasaki’s Disease

Cardiology ◽  
2002 ◽  
Vol 97 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Dennis W. Dunning ◽  
Mary E. Hussey ◽  
Thomas Riggs ◽  
Ronald Bestervelt ◽  
Cindy Goerke
Keyword(s):  
Long Term Follow Up ◽  
Kawasaki’S Disease ◽  
Kawasaki's Disease

Coronary angiography to assess progression of coronary stenosis after Kawasaki's disease

1992 ◽  
Vol 1 (1) ◽  
pp. 78
Author(s):  
Elfriede Pahl-Schuette ◽  
William H. Neches ◽  
Lee B. Beerman ◽  
Jose A. Ettedgui ◽  
Sang C. Park
Keyword(s):  
Coronary Angiography ◽  
Coronary Stenosis ◽  
Kawasaki’S Disease ◽  
Kawasaki's Disease

Prevalence of asymptomatic coronary arterial abnormalities detected by angiography in grown-up patients with congenital heart disease

2001 ◽  
Vol 11 (6) ◽  
pp. 614-618 ◽  
Author(s):  
Bella Koifman ◽  
Rob Egdell ◽  
Jane Somerville
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Cardiac Disease ◽  
Congenital Heart ◽  
Coronary Arteriography ◽  
Clinical Indication ◽  
Congenital Cardiac Disease ◽  
High Incidence

Aims: Coronary arterial abnormalities, congenital and acquired, may co-exist with structural congenital malformations of the heart. This study analyses information obtained from coronary angiography in grown-up patients with congenital cardiac disease undergoing cardiac catheterisation. Methods and Results: We studied 448 patients, of whom 181 (40%) had selective coronary angiography. This was undertaken as a routine measure in 165 (37%), and because of clinical indications in 16 (4%). Aortic root angiography was carried out in 107 (24%). Coronary arterial abnormalities were demonstrated in one-third of those undergoing selective angiography, and in 69% of those with a clinical indication for angiography, compared with 30% who had a routine procedure. In those patients undergoing aortography alone, abnormalities were recognized in 17%, while the angiographic images were inconclusive in 24%. In the remaining 59%, no abnormality was apparent, but only the proximal coronary arteries could be seen clearly. In total, congenital abnormalities of the coronary arteries were found in 11% of the patients, acquired lesions were demonstrated in 5%, and surgically acquired lesions in 2%. Conclusion: Routine coronary angiography during catheterization of grown-up patients with congenital heart disease revealed a high incidence of abnormalities of the coronary arteries. Selective injection into the arteries had a higher sensitivity than aortography. Consideration should be given to performing routine coronary arteriography during invasive investigation of patients with congenital cardiac disease, as it provides useful and often unexpected information, which may be valuable for the interpretation of symptoms and the planning of subsequent surgery.

scholarly journals Multislice computed tomography in the evaluation of coronary atherosclerosis dynamics: data three-year observation in patients with myocardial infarction-segment elevation ST and stenting of coronary arteries

2021 ◽  
Vol 27 (6) ◽  
pp. 19-30
Author(s):  
L. M. Babii ◽  
V. O. Shumakov ◽  
O. P. Pogurelska ◽  
A. Yu. Rybak ◽  
I. E. Malynovska ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Multislice Computed Tomography ◽  
Atherosclerotic Lesions ◽  
Msct Coronary Angiography ◽  
Coronary Artery Stenting ◽  
Progression Of Atherosclerosis

The aim – to use multislice computed tomography (MSCT)-coronary angiography data to determine the presence of atherosclerotic process progression in coronary vessels in the dynamics of the three-year follow-up period in patients after STEMI and coronary artery stenting.Materials and methods. 66 MSCT-coronary angiography studies were performed in 19 men after primary myocardial infarction with ST-segment elevation (STEMI) and coronary artery stenting. All patients were male, ranging in age from 38 to 66 years, with a mean (Me 55.6; (Q1–Q3 (49–64)) years, and 18 of 19 (94.0 %) patients developed Q-MI. 1 patient (6 %) had non-Q-MI. A month after acute MI, patients underwent MSCT of the heart with coronary vascular contrast. Re-examination was performed one, two and three years after the development of STEMI. According to the results of MSCT coronary angiography determined the functional status of stents, as well as the presence or exclusion of signs of restenosis (about 50 % or more) or thrombosis 100 % – occlusion) in the stent coronary artery and in non-infarction-causing arteries. With the progression of atherosclerotic plaque, an increase in atherosclerotic plaque of more than 20 % was taken into account compared to the previous study.Results and discussion. By the end of the first year after MI in 11 of 19 (57.9 %) patients according to MSCT-coronary angiography, no progression of atherosclerotic lesions of the coronary arteries was observed. 1 patient (5.6 %) had stent restenosis, which was confirmed by CAG data. Progression of atherosclerotic lesions was observed in 7 patients (36.8 %), 3 of them (16.6 %) in the stent artery, and in 4 patients in the non-infarction-causing artery. In the second year after myocardial infarction, compared with the annual examination, in 6 of 14 (42.9 %) no progression of atherosclerosis was observed, and in 7 of 14 (50 %) progression of atherosclerotic lesions not in the stent artery, and only in 1 of 14 – progression of atherosclerosis in the stent artery. In the third year after the development of MI, 10 of 14 (71.4 %) had no progression of atherosclerosis, and 4 patients showed progression in both IOA and other arteries.Conclusions. MSCT coronary angiography is an informative method in assessing the functional status of stents and determining the progression of coronary atherosclerosis in the infarct-causing artery and other coronary arteries in patients after MI and coronary artery stenting in the dynamics of three-year follow-up. The lack of progression of atherosclerosis was accompanied by slightly lower levels of low-density lipoprotein cholesterol, compared with patients with progression of atherosclerosis.

scholarly journals A Comparison of SAA Levels in Children With Viral CNS Infection and Kawasaki’s Disease

2020 ◽  
Author(s):  
Hui Yang ◽  
Ran Huo
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Systemic Vasculitis ◽  
Cns Infection ◽  
Chi Square ◽  
Chi Square Test ◽  
Kawasaki’S Disease ◽  
High Level ◽  
Kawasaki's Disease

Abstract Background: The purpose of this study was to analyze the epidemiological differences of SAA in children with viral central nervous system (CNS) infection and Kawasaki’s Disease(KD). The former is viral invasion of central nervous system, whereas the latter is a viral systemic vasculitis. Differences in the SAA concentration in the blood and the proportion of high level SAA cases reflected the influence of the blood-cerebrospinal fluid barrier (BCB) on the concentration of peripheral blood infection markers.Methods: The SAA data comprised 226 consecutive cases of children, including 112 cases of viral CNS infection and 114 cases of KD. Differences in the proportion and concentration of SAA in the cases of the two groups were verified with a Kruskal-Wallis H-test and the chi-square test.Results: The concentration of SAA differed between children with KD and viral CNS infection, and the high level SAA proportion was lower in children with viral CNS infection compared to that in the KD group.Conclusions: The observed differences may be due to the sequestration effect, as the blood-cerebrospinal fluid barrier (BCB) can compartmentalize the pathogens at the site of disease. Therefore, other organs are unable to be stimulated to release additional SAA.

scholarly journals Stress testing-guided assessment of coronary artery bypass grafts patency, at 6 months of follow up. A prospective study

2021 ◽  
pp. 21-29
Author(s):  
Boukhmis Abdelkader ◽  
Nouar Mohamed El-Amin
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Artery Bypass ◽  
Coronary Arteries ◽  
Artery Bypass ◽  
Bypass Grafts ◽  
Repeat Revascularization ◽  
Coronary Bypass Grafts

Purpose: To assess the coronary bypass grafts patency and the repeat revascularization rate, six months after coronary artery bypass grafting (CABG). Methods: We prospectively enrolled 145 consecutive patients undergoing isolated CABG between June 2014 and June 2016. We performed at 6 months of follow up a coronary computed tomography angiography (CTA) in patients whose stress tests were negative and an invasive coronary angiography (ICA) in the opposite case. Results: A total of 134 CTA and 11 ICA were performed, allowing the analysis of 321 grafts, including 143 left internal thoracic arteries (LITA), 89 right internal thoracic arteries (RITA) and 89 saphenous veins grafts (SVG). The average graft patency was 95.1% for LITA, 84.3% for RITA and 64% for SVG. The best patencies were obtained when these grafts were anastomosed to the left anterior descending artery (LAD): 96.3% for LITA, and 87.5% for RITA. SVG patency was homogeneous whether between the main right coronary artery and its branches (63.4% versus 65% respectively. p = 1), or between circumflex and RCA (72.7% versus. 63.9% respectively. p=0.6). On the right and circumflex coronary arteries, the patency of the SVG was significantly lower than that of RITA (66.26% versus 83.95% respectively, p = 0.011). At 6 months of follow up, the repeat revascularization rate was 2.07% (n=3/145). Conclusions: 6 months after CABG, RITA and LITA had good patencies especially on LAD, while SVG was occluded in almost a third of cases. On the circumflex and right coronary arteries, SVG patency was significantly lower than that of RITA. Keywords: Coronary Artery Bypass; Exercise Testing; Coronary Angiography; Computed Tomography Angiograph

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