Open Access Highly Accessed Research article

Assessment of coronary artery intimal thickening in patients with a previous diagnosis of Kawasaki disease by using high resolution transthoracic echocardiography: our experience

Valentina Giacchi*, Pietro Sciacca, Ileana Stella, Martina Filippelli, Patrizia Barone, Mario La Rosa and Salvatore Leonardi

Author Affiliations

Pediatric Pneumo-Allergology and Cystic Fibrosis Department, Pediatric Cardiology Clinic, AOU “Policlinico-Vittorio Emanuele”, University of Catania, Catania, Italy

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BMC Cardiovascular Disorders 2014, 14:106  doi:10.1186/1471-2261-14-106

Published: 20 August 2014

Abstract

Background

Kawasaki disease (KD) is a generalized systemic vasculitis of unknown etiology involving medium and small size blood vessels, particularly the coronary arteries. In these vessels a progressive stenosis may result from active remodeling with an intimal proliferation and neoangiogenesis. The aim of our study was to assess, by using high-resolution transthoracic 2D Echocardiography, if subjects with a previous diagnosis of Kawasaki disease after several years show a coronary intimal thickening, suggestive of a persistent cardiovascular risk.

Methods

We assessed measurement of thickening, inner diameter and outer diameter of coronary arteries using 2D Echocardiography (Philips E 33 with multy-frequency S8-3 and S12-4 probes) and examining the proximal portion of left main coronary artery just above the aortic valve with parasternal short axis view.

Results

We found a significant intimal thickening in patients with previous Kawasaki disease compared to healthy controls. In particular, we noticed that also subjects not suffering from coronary impairment in acute phase have higher values of thickening than healthy controls, and this wall thickening may confer a higher cardiovascular risk.

Conclusions

Therefore we concluded that the assessment of coronary artery thickening by high-resolution transthoracic 2D Echocardiography may become an essential instrument to evaluate late cardiovascular risk in subjects with a diagnosis of Kawasaki disease in childhood.

Keywords:
Kawasaki disease; High resolution transthoracic echocardiography; Cardiovascular risk; Coronary intimal thickening