Children with kawasaki disease present elevated stiffness of great arteries: Phase‐contrast MRI study

Abstract

Patients with KD have elevated great vessel stiffness measured at the chronic stage of the disease. Accelerated stiffness process does not appear to affect biventricular function in youth Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1228-1236.

Cardiovascular Involvement in Kawasaki Disease Is Much More Than Mere Coronary Arteritis

“…Increase in stiffness of aorta and decrease in elasticity has also been reported by several authors leading to functional impairment of aorta. This has been observed both during the acute stage and several years after the diagnosis of KD ( 104 – 106 ).…”

Expression of CD40 Ligand on T Cells and Soluble CD40 Ligand in Children With Kawasaki Disease

“…sCD40L can interact with CD40 present on a variety of cells in the blood vessels leading to inflammation and an atherogenic potential 10–19 . It has been postulated that KD may have long-term cardiovascular sequelae even when there have been no overt CAA during acute stage 20–31 . Although there are several differences in the pathogenesis of KD vasculopathy and atherosclerotic heart disease, several studies have also shown that patients with KD have an increased risk of premature atherosclerosis as assessed using flow-mediated dilatation of brachial artery or carotid intima media thickness 19–33 .…”

“…[10][11][12][13][14][15][16][17][18][19] It has been postulated that KD may have long-term cardiovascular sequelae even when there have been no overt CAA during acute stage. [20][21][22][23][24][25][26][27][28][29][30][31] Although there are several differences in the pathogenesis of KD vasculopathy and atherosclerotic heart disease, several studies have also shown that patients with KD have an increased risk of premature atherosclerosis as assessed using flow-mediated dilatation of brachial artery or carotid intima media thickness. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Long-term vasculopathy in patients with KD is characterized by chronic inflammation, endothelial dysfunction, luminal fibroblast proliferation, and thrombosis.…”

“…[20][21][22][23][24][25][26][27][28][29][30][31] Although there are several differences in the pathogenesis of KD vasculopathy and atherosclerotic heart disease, several studies have also shown that patients with KD have an increased risk of premature atherosclerosis as assessed using flow-mediated dilatation of brachial artery or carotid intima media thickness. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Long-term vasculopathy in patients with KD is characterized by chronic inflammation, endothelial dysfunction, luminal fibroblast proliferation, and thrombosis. 1 Increased CD40L levels seen in patients with KD despite standard treatment, as was seen in our study, may be one of the potential mechanisms for cardiovascular injury in these patients.…”