Abstract
It remains to be determined the nature and period of vascular endothelial damage by a systemic vasculitis in the acute phase of Kawasaki disease (KD). To elucidate the impact of systemic vasculitis of acute KD on peripheral arterial dimension and reactivity, using high-resolution ultrasound system (Toshiba SSA 380A system with 7.5MHz linear-array transducer) vasodilative response to reactive hyperemia of brachial artery was evaluated in 23 children with acute KD (1.3±1.0 months after onset), 10 in recovery phase (10±2.6 months) and 33 age- and sex- matched control subjects (C). The reactive hyperemia was obtained by the pneumatic tourniquet inflated on the forearm to 180mmHg for 3 minutes and released. Baseline diameters of brachial artery were significantly enlarged both in acute KD (2.8±0.35mm, p<0.0001) and in recovery (2.7±0.23mm, p<0.05), compared with that in C (2.4±0.37mm). Percent of normal value for body surface area in brachial diameter, however, significantly improved in recovery than that in acute KD (113±10% vs 124±13%, p<0.05). Flow-mediated dilatation (% increase of diameter) was significantly depressed in acute KD (0.78±4.5% vs 16±5.0% in C, p<0.0001) and also improved in recovery (12±7.0%, p<0.0001). We concluded that systemic vasculitis of acute KD induces pathological peripheral vasodilatation and impairs vascular reactivity to hyperemia, which potentially improves in recovery phase.
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Sano, T., Itagaki, Y., Koike, M. et al. Potentially Reversible Brachial Vasodilatation and Impaired Flow-mediated Reactivity in Acute Kawasaki Disease. Pediatr Res 53, 183 (2003). https://doi.org/10.1203/00006450-200301000-00178
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DOI: https://doi.org/10.1203/00006450-200301000-00178