Abstract
Even IVIG was established as a standard of care for patients with Kawasaki disease, there are still significant numbers of patients who developed coronary artery abnormality (CAA) or were resistant to therapy. Inflammation at the walls of these arteries has been demonstrated earlier during the acute phase. Direct analysis on these sites may reflect the ongoing pathological process. The purpose of our study was to quantitatively analyze the videodensity (VD) of the coronary arterial walls indexed to that of myocardium (videodensity index-VDI). The VDI was evaluated as a potential predictor for subsequent CAA. Patients who fulfilled the diagnostic criteria, ranging in age from 2 months to 9 years, were studied. All the patients ware treated with IVIG 1-2 gm/kg. An HP Sonos 4500 echocardiographic system was used to acquire images of the coronary arteries. Optimal images of the major branches of the coronary arteries including the right ventricular free wall myocardium were digitally captured and analyzed for VD using the NIH Image software. The echocardiographic studies were performed at the time of diagnosis, 2 months, and 6 months later. Sixty-two of 72 patients (86%) had adequate echocardiographic images for analysis. Eleven patients developed small (6), medium (2), and giant (3) coronary artery aneurysms. The VDIs in acute phase ranged from 0.50 to 2.49. The ROC curve analysis using SPSS identified an optimal VDI cut-off at 1.32 with sensitivity of 82% and specificity of 78% for predicting the CAA. The mean interobserver variability of the measurement was 5%. In conclusion, echocardiographic videodensity index of the coronary arterial wall may predict for the subsequent occurrence of coronary artery abnormality in patients with Kawasaki disease.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wanitkun, S., Khowsathit, P., Khositset, A. et al. Echocardiographic Videodensity Index of the Coronary Arteries in Kawasaki Disease: A Predictor for Subsequent Coronary Artery Abnormality. Pediatr Res 53, 184 (2003). https://doi.org/10.1203/00006450-200301000-00182
Issue Date:
DOI: https://doi.org/10.1203/00006450-200301000-00182