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Urbano N, Scimeca M, Bonfiglio R, Bonanno E, Schillaci O. [Possible role of 99mTC-Sestamibi scintigraphy in the follow-up of Kawasaki-like disease related to SARS-CoV-2]. Rev Esp Med Nucl Imagen Mol 2022; 41:201. [PMID: 35372137 PMCID: PMC8495080 DOI: 10.1016/j.remn.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- N Urbano
- Nuclear Medicine Unit, Department of Oncohaematology, Policlínico "Tor Vergata", Rome, Italia
| | - M Scimeca
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italia
- San Raffaele University, Rome, Italia
- Saint Camillus International University of Health Sciences, Rome, Italia
| | - R Bonfiglio
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italia
| | - E Bonanno
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italia
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Crean A, Benson L, Shah A, Han K, Lesser J, McCrindle BW. Imaging the delayed complications of childhood Kawasaki disease. F1000Res 2022; 11:147. [PMID: 36970577 PMCID: PMC10036956 DOI: 10.12688/f1000research.73097.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/20/2022] Open
Abstract
This review will discuss the long-term complications of Kawasaki disease with a particular focus on imaging surveillance of the coronary arteries in adolescence and adult life. The relative advantages and disadvantages of each modality will be illustrated with practical examples, demonstrating that, in many cases, a multimodality imaging strategy may be required.
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Affiliation(s)
- Andrew Crean
- Cardiology, University of Ottawa Heart Institute, Ottawa, ON, K1Y 4W7, Canada
| | - Lee Benson
- Cardiology, Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada
| | - Ashish Shah
- Cardiology, St Boniface Hospital, Winnipeg, Manitoba, R2H 2A6, Canada
| | - Kelly Han
- Cardiology, Children's Minnesota Hospital, Minneapolis, MN, 55404, USA
| | - John Lesser
- Cardiology, Minneapolis Heart Institute, Minneapolis, MN, 55407, USA
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Weng AM, Köstler H, Bley TA, Ritter CO. Effect of short-term smoking & L-arginine on coronary endothelial function assessed by cardiac magnetic resonance cold pressor testing: a pilot study. BMC Cardiovasc Disord 2021; 21:237. [PMID: 33980159 PMCID: PMC8114700 DOI: 10.1186/s12872-021-02050-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 05/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background The effect of smoking on coronary vasomotion has been investigated in the past with various imaging techniques in both short- and long-term smokers. Additionally, coronary vasomotion has been shown to be normalized in long-term smokers by L-Arginine acting as a substrate for NO synthase, revealing the coronary endothelium as the major site of abnormal vasomotor response. Aim of the prospective cohort study was to investigate coronary vasomotion of young healthy short-term smokers via magnetic resonance cold pressor test with and without the administration of L-Arginine and compare obtained results with the ones from nonsmokers. Methods Myocardial blood flow (MBF) was quantified with first-pass perfusion MRI on a 1.5 T scanner in healthy short-term smokers (N = 10, age: 25.0 ± 2.8 years, 5.0 ± 2.9 pack years) and nonsmokers (N = 10, age: 34.3 ± 13.6) both at rest and during cold pressor test (CPT). Smokers underwent an additional examination after administration of L-Arginine within a median of 7 days of the naïve examination. Results MBF at rest turned out to be 0.77 ± 0.30 (smokers with no L-Arginine; mean ± standard deviation), 0.66 ± 0.21 (smokers L-Arginine) and 0.84 ± 0.08 (nonsmokers). Values under CPT were 1.21 ± 0.42 (smokers no L-Arginine), 1.09 ± 0.35 (smokers L-Arginine) and 1.63 ± 0.33 (nonsmokers). In all groups, MBF was significantly increased under CPT compared to the corresponding rest examination (p < 0.05 in all cases). Additionally, MBF under CPT was significantly different between the smokers and the nonsmokers (p = 0.002). MBF at rest was significantly different between the smokers when L-Arginine was given and the nonsmokers (p = 0.035). Conclusion Short-term smokers showed a reduced response to cold both with and without the administration of L-Arginine. However, absolute MBF values under CPT were lower compared to nonsmokers independently of L-Arginine administration.
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Affiliation(s)
- Andreas M Weng
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
| | - Herbert Köstler
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Thorsten A Bley
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Christian O Ritter
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.,Institute for Diagnostic and Interventional Radiology, University Medicine Goettingen, Goettingen, Germany
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Urbano N, Scimeca M, Bonfiglio R, Bonanno E, Schillaci O. Possible role of 99mTC-Sestamibi scintigraphy in the follow-up of Kawasaki-like disease related to SARS-CoV-2. Rev Esp Med Nucl Imagen Mol 2021; 41:201. [PMID: 35577499 PMCID: PMC7945867 DOI: 10.1016/j.remnie.2021.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Zhang D, Liu L, Huang X, Tian J. Insights Into Coronary Artery Lesions in Kawasaki Disease. Front Pediatr 2020; 8:493. [PMID: 32984207 PMCID: PMC7477115 DOI: 10.3389/fped.2020.00493] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 07/14/2020] [Indexed: 12/14/2022] Open
Abstract
This review summarizes recent advances in understanding the development of coronary arteritis in Kawasaki disease. Kawasaki disease is the most common cause of acquired heart disease among children characterized with coronary artery abnormalities, which can cause myocardial ischemia, infarction, and even death. The pathogenic factors of Kawasaki disease and the pathological process of coronary artery disease are not clear at present, which brings challenges to the prevention and treatment of the disease. The treatment of Kawasaki disease focuses mainly on timely administration of intravenous high doses of immunoglobulin and aspirin. However, there are still some patients who do not respond well to this standard treatment, and its management remains a challenge. As a result, coronary artery lesions still occur in patients and affect their quality of life. In this review, we discuss updated research data of Kawasaki disease coronary artery lesions.
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Affiliation(s)
- Danfeng Zhang
- Ministry of Education Key Laboratory of Child Development and Disorders, Department of Cardiology, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Lingjuan Liu
- Ministry of Education Key Laboratory of Child Development and Disorders, Department of Cardiology, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xupei Huang
- Department of Biomedical Science, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States
| | - Jie Tian
- Ministry of Education Key Laboratory of Child Development and Disorders, Department of Cardiology, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
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Carotid Intima-Media Thickness and Lipid Profile in Children With Kawasaki Disease: A Single-Center Follow-up Study After a Mean Duration of 6.9 Years. J Clin Rheumatol 2019. [PMID: 29538084 DOI: 10.1097/rhu.0000000000000754] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Kawasaki disease (KD) has a predilection to involve coronary arteries, leading to several long-term cardiovascular sequelae. Apart from coronary artery abnormalities, children with KD are also prone to develop premature atherosclerosis, endothelial dysfunction, and lipid abnormalities. Some of these complications may occur even in children who have received appropriate treatment with intravenous immunoglobulin in the acute phase. METHODS In 2009, we had studied carotid intima-media thickness (cIMT) and lipid profile in 27 children with KD at least 1 year after the acute episode. In the present study, we have followed up the same cohort of 27 children at least 5 years after the acute episode of KD. We measured the cIMT, a surrogate marker for premature atherosclerosis, and fasting lipid profile in the cohort and compared the results with values obtained in our previous study. RESULTS There was significantly higher mean cIMT in children with KD as compared with control subjects. However, there was no significant difference in cIMT among children in the cohort at 1 and 5 years of follow-up. Abnormal lipid profile was seen in 7 of 27 children in the present study, 5 of whom also had had lipid abnormality at 1-year follow-up. This suggests that lipid abnormalities in KD may be long lasting. CONCLUSIONS Children with KD need careful long-term follow-up even when they do not have overt and persistent coronary artery abnormalities. It is possible that consequences of KD in childhood may impact health status of young adults several years later.
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Dionne A, Ibrahim R, Gebhard C, Benovoy M, Leye M, Déry J, Lapierre C, Girard P, Fournier A, Dahdah N. Difference Between Persistent Aneurysm, Regressed Aneurysm, and Coronary Dilation in Kawasaki Disease: An Optical Coherence Tomography Study. Can J Cardiol 2018; 34:1120-1128. [PMID: 30093299 DOI: 10.1016/j.cjca.2018.05.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 05/29/2018] [Accepted: 05/29/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Coronary artery (CA) aneurysms are a serious complication of Kawasaki disease (KD). Conventional imaging techniques often described segments with regressed aneurysms as normal, whereas studies have shown significant endothelial dysfunction. METHODS KD patients with aneurysms scheduled for routine coronary angiography underwent optical coherence tomography (OCT) imaging between 2013 and 2016. Microstructural coronary changes were compared between normal CA segments and those with dilation, regressed aneurysms, and persistent aneurysms. RESULTS OCT was performed on 33 patients aged 12.0 ± 5.4 years, 8.5 ± 5.4 years after KD diagnosis. Of the 79 segments analyzed, 25 had persistent aneurysms, 22 regressed aneurysms, 11 CA dilation, and 21 no CA involvement. Intimal thickness was 489 ± 173 μm, 304 ± 158 μm, 102 ± 68 μm, and 63 ± 29 μm, respectively (P < 0.001). There was a linear correlation between the maximum aneurysm size and the intimal thickness, as well as coronary dimension at the time of OCT. Fibrosis (54 segments, 68%) and cellular infiltration (22 segments, 28%) were found more often in segments with CA involvement, but also those without (P = 0.01; P = 0.02). Destruction of the media (34 segments, 43%), calcifications (6 segments, 8%), neovascularization (18 segments, 23%), and white thrombi (8 segments, 10%) were found almost exclusively in segments with a history of aneurysms. CONCLUSIONS Intimal hyperplasia, fibrosis, and cellular infiltration were found in all categories of CA involvement, whereas calcification, destruction of the media, neovascularization, and white thrombi were found essentially only in segments with saccular or fusiform aneurysms. Prospective studies with outcome correlations are needed to see if this is associated with an increased risk of late adverse events.
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Affiliation(s)
- Audrey Dionne
- Department of Cardiology, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA; Division of Pediatric Cardiology, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Ragui Ibrahim
- Division of Cardiology, Pierre Boucher Hospital, Longueuil, Quebec, Canada
| | - Catherine Gebhard
- Center for Molecular Cardiology, University of Zurich, and Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Mitchel Benovoy
- Division of Applied Sciences, Corstem Inc. Montreal, Quebec, Canada
| | - Mohamed Leye
- Division of Pediatric Cardiology, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Julie Déry
- Division of Radiology, CHU Ste-Justine, Montreal, Quebec, Canada
| | | | - Patrice Girard
- Division of Pediatric Cardiology, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Anne Fournier
- Division of Pediatric Cardiology, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Nagib Dahdah
- Division of Pediatric Cardiology, CHU Sainte-Justine, Montreal, Quebec, Canada.
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Gupta A, Singh S, Gupta A, Suri D, Rohit M. Aortic stiffness studies in children with Kawasaki disease: preliminary results from a follow-up study from North India. Rheumatol Int 2014; 34:1427-32. [PMID: 24696188 DOI: 10.1007/s00296-014-3000-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 03/24/2014] [Indexed: 11/26/2022]
Abstract
Kawasaki disease (KD) is an acute medium vessel vasculitis seen in children. Coronary artery abnormalities are the most notable long-term complications. Intravenous immunoglobulin therapy has led to significant reduction in incidence of coronary aneurysms. However, higher risk of cardiovascular disease has been noted even in those children who have never been reported to develop coronary artery aneurysms during the subacute phase. Noninvasive estimation of this cardiovascular risk is useful in initiating timely preventive strategies. Arterial stiffness has been shown to be an independent predictor of cardiovascular events in general population. This study was aimed at measuring abdominal aorta stiffness in a cohort of children with KD from North India. Thirty children diagnosed to have KD at least 5 years prior to enrollment were evaluated by echocardiography for cardiac and abdominal aorta studies. Electrocardiographs were done in all patients for QT dispersion. There was a noticeable trend toward lower aortic strain, higher pressure strain elastic modulus and normalized pressure strain elastic modulus in children in the study group, though this difference did not reach statistical significance. Mean corrected QT dispersion was significantly higher in cases compared with controls. On cardiac evaluation, none of the subjects had any residual coronary artery involvement. A trend toward lower distensibility and higher stiffness of abdominal aorta was seen in cases compared with controls, though it was not found to be statistically significant. This could be a predictor of premature atherosclerosis in long term. Significantly higher QT dispersion was seen in cases compared with controls. More multicentric studies with larger sample size and longer follow-up periods are needed to clarify this issue.
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Affiliation(s)
- Anand Gupta
- Pediatric Allergy Immunology Unit, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Meena RS, Rohit M, Gupta A, Singh S. Carotid intima-media thickness in children with Kawasaki disease. Rheumatol Int 2013; 34:1117-21. [PMID: 23925993 DOI: 10.1007/s00296-013-2820-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 07/03/2013] [Indexed: 02/05/2023]
Abstract
Kawasaki disease (KD) is an acute medium vessel vasculitis seen in children. The most significant long-term complication is related to coronary artery abnormalities. Use of intravenous immunoglobulins, however, has led to significant reduction in incidence of coronary aneurysms. What is more alarming is the fact that higher risk of cardiovascular disease is seen in even those children who do not have coronary artery aneurysms during subacute phase. Various factors like abnormal lipid profiles, abnormal vessel wall reactivity and endothelial dysfunction have been implicated for this. Carotid intima-media thickness (cIMT) has been used as a surrogate marker for atherosclerosis. This study was planned to evaluate cIMT in children with KD. Twenty-seven children with diagnosis of KD at least 1 year prior to enrolment were evaluated for cIMT at enrolment and then after 3 months. Fasting lipid profile was done for all patients. Mean cIMT was significantly higher in children with KD compared to controls. In lipid profiles, undesirable HDL-C and triglyceride levels were seen in 2 and 3 children, respectively. Undesirable and borderline LDL-C levels were seen in 1 and 2 patients, respectively. Undesirable and borderline total cholesterol levels were seen in 1 and 3 patients, respectively. Higher cIMTs were seen in our cohort of KD patients. Proatherogenic abnormalities in lipid profile were seen in a few patients. Both abnormalities may predict a higher risk of atherosclerosis in future. The results of this study need to be replicated on a larger study sample and over longer follow-up periods.
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Affiliation(s)
- Raghvendra Singh Meena
- Departments of Cardiology, Advanced Cardiac Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Yim D, Curtis N, Cheung M, Burgner D. An update on Kawasaki disease II: clinical features, diagnosis, treatment and outcomes. J Paediatr Child Health 2013; 49:614-23. [PMID: 23647873 DOI: 10.1111/jpc.12221] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2012] [Indexed: 01/30/2023]
Abstract
This is the second of two updates on Kawasaki disease. The first review focused on epidemiology and aetio-pathogenesis. Here, we review the clinical features and diagnosis of Kawasaki disease, as well as recent evidence on treatment, follow-up and cardiovascular outcomes.
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Affiliation(s)
- Deane Yim
- Department of Cardiology, The University of Melbourne, Melbourne, Victoria, Australia
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