Abstract
Coronary arteritis associated with Kawasaki disease (KD) raises concern about the premature development of arteriosclerosis. Accordingly, we investigated endothelial function in the epicardial, resistance CAs, and femoral arteries (FAs) after KD during long-term observation. We assessed the responses of left epicardial and resistance CAs to serial intracoronary infusions of acetylcholine (final concentrations, 0.1 and 1 micromol/L) and nitroglycerin in subjects by using quantitative angiography and a Doppler flow wire system. Three age-matched groups were evaluated: 8 control subjects (group 1), 10 KD patients with normal left CA from the onset (group 2), and 8 KD patients with a persistent or regressed aneurysm in the left anterior descending CA (L AD) (group 3). Acetylcholine (1 micromol/L) changed the LAD area to 114.0+/-2.6%, 72.7+/-3.9% (P<.05 versus group 1), and 88.9+/-4.3% (P< .05 versus groups 1 and 2) of baseline in groups 1, 2, and 3, respectively, with a similar degree of increased coron ary blood flow in each group. Nitroglycerin increased the LAD area to 143.5+/-7.7%, 132.3+/-1.9%, and 120.8+/-5.6% (P< .05 versus group 1), respectively. Nextly, we evaluated the reactive hyperemia- or sublingual nitroglycerin-induced FA dilatation b y high-resolution ultrasound in two age-matched groups: 13 controls, and 13 KD patients with persistent or regressed aneurysms in 4 and normal CAs in 9 patients. There were no differences in the FA responses to reactive hyperemia or nitroglycerin betwee n the two groups. Results demonstrate a persistent endothelial dysfunction in the “uninvolved” epicardial but neither in resistance CAs nor in FAs after KD, suggesting systemic heterogeneity of endothelial function in this disorder.
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Mitani, Y., Okuda, Y., Shimpo, H. et al. Systemic Heterogeneity of Endothelial Function after Kawasaki Diseases. Pediatr Res 53, 185 (2003). https://doi.org/10.1203/00006450-200301000-00192
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DOI: https://doi.org/10.1203/00006450-200301000-00192