Research article

Oxidative stress in children late after Kawasaki disease: relationship with carotid atherosclerosis and stiffness

Yiu-fai Cheung¹ , Karmin O^2,3 , Connie WH Woo^2,3 , Stephanie Armstrong^2,3 , Yaw L Siow^2,3 , Pak-cheong Chow¹ and Eddie WY Cheung¹

¹Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Grantham Hospital, The University of Hong Kong, Hong Kong, China

²Canadian Centre for Agri-Food Research in Health and Medicine, Department of Animal Science, University of Manitoba, Winnipeg, Canada

³Department of Physiology, University of Manitoba, Winnipeg, Canada

author email corresponding author email

BMC Pediatrics 2008, 8:20doi:10.1186/1471-2431-8-20

Published:	8 May 2008

Abstract

Background

Persistent arterial dysfunction in patients with a history of Kawasaki disease (KD) and an integral role of oxidative stress in the development of cardiovascular disease are increasingly recognized. We sought to test the hypothesis that oxidative stress is increased in KD patients and related to carotid atherosclerotic changes and stiffness.

Methods

We compared the serum levels of oxidative stress biomarkers, carotid intima-media thickness (IMT), and carotid stiffness index among KD patients with coronary aneurysms (n = 32), those without coronary complications (n = 19), and controls (n = 32).

Results

Compared with controls, patients with coronary aneurysms had significantly higher serum levels of malonaldehyde (2.62 ± 0.12 μM vs 2.22 ± 0.07 μM, p = 0.014) and hydroperoxides (26.50 ± 1.13 μM vs 22.50 ± 0.62 μM, p = 0.008). A linear trend of the magnitude of oxidative stress in relation to inflammatory damage was observed for malonaldehyde (p = 0.018) and hydroperoxides (p = 0.014) levels. Serum malonaldehyde and hydroperoxide levels correlated positively with carotid IMT (p < 0.001 and p = 0.034, respectively) and stiffness index (p = 0.001 and p = 0.021, respectively). Multiple linear regression analysis identified serum malonaldehyde level as a significant determinant of carotid IMT (β = 0.31, p = 0.006) and stiffness (β = 0.27, p = 0.008).

Conclusion

Our findings suggest oxidative stress is increased in KD patients with coronary aneurysms and is associated with carotid intima-media thickening and stiffening.