Abstract
We examined whether Kawasaki disease (KD) patients without coronary artery lesion (CAL) would develop some cardiac abnormality at late stage. Methods. Study patients were 162 children of 335 Kawasaki Disease patients admitted to our hospital from 1982-1990 and started the treatment within 10th illness day. 272 out of 335 pts had no coronary artery lesion at acute stage. At both 5 yrs and 10 yrs after onset, three kinds of cardiac examinations (echocardiogram, treadmill exercise test, 24-h electrocardiogram) underwent in 162 out of 272 pts without CAL. They were 84 boys and 78 girls and their age at onset was average of 2.04-year-old (0.2-6.8). The patients with positive outcomes of three tests underwent myocardial perfusion imaging and/or coronary angiography as further investigation. Results. Abnormal cardiac findings consisted of left ventricular wall motion abnormality, mitral valve prolapse, ST segment depression with exercise, complex ventricular arrhythmia and sinus pause more than 2.5 seconds. The number of patients with positive outcome is 9 and 16 in the 5 yrs and 10 yrs after onset, respectively. The positive rate at 10 yrs after onset was significantly higher than that at 5 yrs (p < 0.0001). The age at onset of the patients with positive outcome was significantly higher than that of the others (2.99-year-old, 1.93-year-old, p = 0.006). The illness day started treatment, use of immunoglobulin and fever duration were no difference between the positive cases and the negative cases. Conclusions. This study clarified the presence and gradually increase of cardiac abnormalities in KD patients without CAL at late stage, moreover the necessity to follow up KD patients regardless of coronary status.
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Watanabe, S., Ohta, T. Late Stage Cardiac Abnormalities in the Kawasaki Disease Patient without Coronary Artery Lesion. Pediatr Res 53, 186 (2003). https://doi.org/10.1203/00006450-200301000-00198
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DOI: https://doi.org/10.1203/00006450-200301000-00198