Abstract
The cardiovascular involvement in Kawasaki disease (KD) are most important clinical issues. However, the long-term consequence of cardiovascular sequelae in KD remains uncertain at the present time. In 1973 we introduced coronary angiography (CAG) as a routine cardiac examination. From 1973 to 2000 we experienced 1,970 consecutive patients of acute KD, of which 302 (15.3%) had coronary aneurysms. These patients had been followed for more than 2 years with longest 28 yrs (mean: 7.5 yrs.). Follow-up(2nd) CAG was performed in 280, of which 151 demonstrated the regression of coronary aneurysms (54%). Further follow-up CAG (3rd, 4th, 5th) was done in 130 cases. In the long-term pathological study the regressed aneurysms revealed the marked initial thickening mainly caused by proliferation of medial smooth muscle cells and well degenerated endotherium. Those findings were also demonstrated by intravascular ultrasound imaging in the follow-up patients. Long-term endothelial function in those patients was impaired. From this long-term follow-up study we review our data and discuss the following issues in the long-term problems of pediatric through adults in KD. 1) Cardiovascular spectrum in Kawasaki disease. 2) Fate of coronary aneurysms; Regression of aneurysms and progression to coronary artery disease. 3) KD vasculitis may be an atherosclerotic risk factor. 4) Kawasaki disease is a part of causes of adult coronary artery disease. 5) Therapeutic recommendations, particularly for the catheter interventional treatment.
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Kato, H. Long-Term Issues and Management of Kawasaki Coronary Artery Disease. Pediatr Res 53, 165 (2003). https://doi.org/10.1203/00006450-200301000-00067
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DOI: https://doi.org/10.1203/00006450-200301000-00067