scholarly journals CT Angiography or Cardiac MRI for Detection of Coronary Artery Aneurysms in Kawasaki Disease

2021 ◽  
Vol 9 ◽  
Author(s):  
Diana van Stijn-Bringas Dimitriades ◽  
Nils Planken ◽  
Irene Kuipers ◽  
Taco Kuijpers
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Cardiac Mri ◽  
Diagnostic Yield ◽  
Imaging Modality ◽  
Computed Tomographic Angiography ◽  
Single Center ◽  
Coronary Artery Aneurysms ◽  
Luminal Diameter ◽  
Diagnostic Potential

Background: Kawasaki disease (KD) is an acute vasculitis that mainly affects the coronary arteries. This inflammation can cause coronary artery aneurysms (CAAs). Patients with KD need cardiac assessment for risk stratification for the development of myocardial ischemia, based on Z-score (luminal diameter of the coronary artery corrected for body surface area). Echocardiography is the primary imaging modality in KD but has several important limitations. Coronary computed tomographic angiography (cCTA) and Cardiac MRI (CMR) are non-invasive imaging modalities and of additional value for assessment of CAAs with a high diagnostic yield. The objective of this single center, retrospective study is to explore the diagnostic potential of coronary artery assessment of cCTA vs. CMR in children with KD.Methods and Results: Out of 965 KD patients from our database, a total of 111 cCTAs (104 patients) and 311 CMR (225 patients) have been performed since 2010. For comparison, we identified 54 KD patients who had undergone both cCTA and CMR. CMR only identified eight patients with CAAs compared to 14 patients by cCTA. CMR missed 50% of the CAAs identified by cCTA.Conclusions: Our single center study demonstrates that cCTA may be a more sensitive diagnostic tool to detect CAAs in KD patients, compared to CMR.

scholarly journals Cardiovascular outcomes following Kawasaki disease in Moscow, Russia: A single center experience

2018 ◽  
Vol 2017 (3) ◽  
Author(s):  
Galina Lyskina ◽  
Olga Bockeria ◽  
Olga Shirinsky ◽  
Alena Torbyak ◽  
Anna Leontieva ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Moscow Region ◽  
Single Center ◽  
Coronary Artery Aneurysms ◽  
Delayed Treatment ◽  
Giant Aneurysms ◽  
Single Center Experience ◽  
Over Time

Background: Awareness of Kawasaki disease (KD) is emerging in Russia but the diagnosis is still often missed. Methods: This is a retrospective study of 303 children with KD who received care at a single center in Moscow over the period from 2004 to 2016. Results: Overall, coronary artery aneurysms were documented in 91 (30,0%) of 303 patients and transient ectasia in 40 (13,2%). Intracoronary thrombi were found in 12 of 15 patients with giant aneurysms and in 3 patients with medium-sized aneurysms. Conclusion: The patients with KD in the Moscow region had typical features of the disease described in the literature but the proportion of patients with coronary artery aneurysms was higher than reported from other countries. We assume that this is due to delayed treatment, which has gradually improved over time. Increased awareness of KD in Russia is critical to ensure timely diagnosis and treatment. 

Abstract O.58: Medium-term Outcomes of Coronary Artery Aneurysms after Kawasaki Disease: A Study from the North American Kawasaki Disease Registry

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Brian W McCrindle ◽  
Cedric Manlhiot ◽  
Kristen Sexson ◽  
Pei-Ni Jone ◽  
Mathew Mathew ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
North American ◽  
Z Score ◽  
Disease Registry ◽  
Coronary Artery Aneurysms ◽  
Luminal Diameter ◽  
The North ◽  
Increased Risk ◽  
Over Time

Background: One of the main impediments to conceiving and planning studies in children with coronary artery aneurysms (CAA) after Kawasaki disease (KD) is the lack of normative data regarding the prevalence of outcomes over time and risk factors. Methods: The North American Kawasaki Disease Registry was used to determine the prevalence of multiple clinically important outcomes of CAA after KD. All analyses were stratified by severity of CAA (small CAA with z-score = 2.5-5, medium with z-score = 5-10 and giant with z-score >10). All analyses were performed using non-parametric survival analysis. Results: n=621 patients submitted to the Registry had complete follow-up data and were included in the analysis (280 [45%] small CAA, 139 [22%] medium and 202 [33%] giant). Time-related freedom from multiple outcomes stratified by type of CAA are reported in the Table. Reduction in z-scores was strongly associated with the initial size of the lesion, with smaller lesions being more likely to decrease to a normal dimension over time. Thrombosis and stenosis were infrequent in patients without giant CAA. For those patients with giant CAA, the risk of thrombosis, myocardial infarction, angiographically-confirmed stenosis and revascularization was substantial and persisted up to 10 years after diagnosis. In addition to larger luminal diameter, other factors associated with increased risk of adverse outcomes included larger CAA longitudinal area and complex CAA (vs. isolated lesions). Conclusions: Only patients with giant CAA are at substantial risk of adverse clinical outcomes; future trials of pharmacological therapy targeting thrombosis and stenosis risk should focus on these patients.

Abstract 221: Use of Statins in Patients with Coronary Artery Aneurysms: A Pilot Study from the North American Kawasaki Disease Registry

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Michael Khoury ◽  
Michael A Portman ◽  
Cedric Manlhiot ◽  
Anne Fournier ◽  
Rejane F Dillenburg ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pilot Study ◽  
Kawasaki Disease ◽  
Linear Regression ◽  
North American ◽  
Z Score ◽  
Disease Registry ◽  
Coronary Artery Aneurysms ◽  
The North ◽  
Significant Difference

Background: Statins have been considered as therapy for children with coronary artery aneurysms (CAA) after Kawasaki disease (KD), due to potential beneficial pleiotropic effects which might influence chronic vascular processes and inflammation. Methods: The North American Kawasaki Disease Registry was queried to identify patients who have received statins in the first 6 months following the convalescent phase of KD. Each identified patient was matched by age, gender and CAA z score to 3 patients who were statin-naïve (controls). Linear regression models adjusted for repeated measures and maximum coronary involvement were used to determine an association of statin use with longitudinal changes in coronary artery diameter z-score. Kaplan-Meier analysis was used to compare freedom from angiographically-confirmed stenosis or interventions. Results: Of 29 patients with KD and CAA (maximum coronary artery z-score >10) who received statins at any time (of n=621, 5%), 10 (9 males) patients were started within 6 months of the acute KD episode. The mean age at KD was 6.3±3.4 years (5.4±3.5 for controls, p=0.57). Mean maximum CAA z-score was 36±14 (vs. 29±16, p=0.20); 90% of statin patients and 87% of matched controls had CAAs in 3 or more branches. Linear regression analysis of 442 serial echocardiograms showed that maximum CAA z-score decreased by -1.5 (95%CI: -2.7; -0.4) SD/year (p=0.008) for control patients compared to -2.9 (95%CI: -4.4; -1.4) SD/year (p<0.001) for statin treated patients. The difference between the rate of change of CAA z-score for statin vs. control patients did not reach statistical significance (controls vs. statins: +1.4 SD/year, 95%CI: -0.6; +3.4, p=0.18). n=7 patients (3 on statin, 4 controls) developed stenosis or had revascularization, with no significant difference between groups (HR for statin group: 2.2 (0.4-11.4), p=0.41). Conclusions: This underpowered pilot study suggests that equipoise likely exists with regards to statin therapy in children with KD and CAA, and that a formal registry-nested trial might be considered.

scholarly journals Genetic variants of glutamate receptor gene family in Taiwanese Kawasaki disease children with coronary artery aneurysms

2014 ◽  
Vol 4 (1) ◽  
pp. 67 ◽  
Author(s):  
Ying-Ju Lin ◽  
Jeng-Sheng Chang ◽  
Xiang Liu ◽  
Hsinyi Tsang ◽  
Ting-Hsu Lin ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Gene Family ◽  
Glutamate Receptor ◽  
Genetic Variants ◽  
Receptor Gene ◽  
Coronary Artery Aneurysms ◽  
Receptor Gene Family

Aerobic exercise function of patients with persistent coronary artery aneurysms secondary to Kawasaki disease

1996 ◽  
Vol 17 (4) ◽  
pp. 226-230 ◽  
Author(s):  
J. Rhodes ◽  
Z. M. Hijazi ◽  
G. R. Marx ◽  
D. R. Fulton
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Aerobic Exercise ◽  
Coronary Artery Aneurysms
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