Abstract
To clarify the incidence of stenotic lesions according to the coronary arterial diameter in the acute phase. we investigated 190 patients with coronary arterial lesions who underwent an initial coronary angiogram (CAG) less than 100 days after the onset of Kawasaki disease. The largest diameters of the major branches were measured in the initial CAGs. The diameter of the large group was ≥8.0 mm, that of the medium group was ≥6.0 mm but <8.0 mm, and that of the small group was ≥4.0 mm but <6.0 mm. There were 121 patients in the large group, 85 in the medium group, 77 in the small group. We investigated the stenotic lesions in the follow-up CAGs and evaluated the incidence of stenotic lesions in each group by the Kaplan–Meier method. The mean interval from the initial CAGs to the latest CAG was 97 months. The incidence of stenosis at 5, 10, and 15 years in the large group was 44, 62, and 74%, respectively. In the medium group the corresponding values were 6, 20, 58%, respectively. None of the patients in the small group developed stenotic lesions. Dilatation of more than 6.0 mm produces a high probability of irreversible change in the coronary arterial wall, leading to subsequent stenotic lesions.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
T Akagi V Rose LN Benson et al. (1992) ArticleTitleOutcome of coronary artery aneurysms after Kawasaki disease J Pediatr 12l 689–694
K Arjunan SR Daniels RA Meyer et al. (1986) ArticleTitleCoronary artery caliber in normal children and patients with Kawasaki disease but without aneurysms. An echocardiographic and angiocardiographic study J A Coll Cardiol 8 1119–1124
H Fujiwara Y Hamashima (1978) ArticleTitlePathology of the heart in Kawasaki disease Pediatrics 62 100–107
S Hiraishi H Misawa N Takeda et al. (2000) ArticleTitleTransthoracic ultrasonic visualization of coronary aneurysm, stenosis and occlusion in Kawasaki disease Heart 83 400–405
H Kato E Ichinose F Yoshioka et al. (1982) ArticleTitleFate of coronary aneurysms in Kawasaki disease: serial coronary angiography and long-term follow-up study Am J Cardiol 49 1758–1766
H Kato S Koike M Yamamoto et al. (1975) ArticleTitleCoronary artery aneurysms in infants and young children with acute febrile mucocutaneous lymph node syndrome J Pediatr 86 892–898
H Kato T Sugimura T Akagi et al. (1996) ArticleTitleLong-term consequences of Kawasaki disease A 10 to 21 year follow-up study of 594 patients. Circulation 94 1379–1385
T Kawasaki (1967) ArticleTitleAcute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children Jpn J Allergy 16 178–222
T Kawasaki F Kosaka S Ozawa et al. (1974) ArticleTitleA new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan Pediatrics 54 271–276
Y Kurisu T Azumi T Sugahara et al. (1987) ArticleTitleVariation in coronary dimension (distensible abnormality) after disappearing aneurysm in Kawasaki disease Am Heart J 114 532–538
H Nakano K Ueda A Saito et al. (1985) ArticleTitleRepeated quantitative angiograms in coronary arterial aneurysm in Kawasaki disease Am J Cardiol 56 846–851
S Naoe K Takahashi H Masuda et al. (1991) ArticleTitleKawasaki disease with particular emphasis on arterial lesions Acta Pathol Japonica 41 785–797
Z Onouchi S Shimazu N Kiyosawa et al. (1982) ArticleTitleAneurysms of coronary arteries in Kawasaki disease: an angiographic study of 30 cases Circulation 66 6–21
Y Sasaguri H Kato (1982) ArticleTitleRegression of aneurysms in Kawasaki disease: a pathological study J Pediatr 100 225–231
T Sugimura H Kato O Inoue et al. (1994) ArticleTitleIntravascular ultrasound of coronary arteries in children: assessment of the wall morphology and the lumen after Kawasaki disease Circulation 89 258–265
A Suzuki T Kamiya Y Arakaki et al. (1994) ArticleTitleFate of coronary arterial aneurysms in patients with Kawasaki disease Am J Cardiol 74 822–824
A Suzuki T Kamiya Y Ono et al. (1988) ArticleTitleMyocardial ischemia in Kawasaki disease: follow-up study by cardiac catheterization and coronary angiography Pediatr Cardiol 9 1–5
A Suzuki T Kamiya E Tsuda et al. (1997) Natural History of Coronary Artery Lesions in Kawasaki Disease Elsevier Amsterdam 211–221
A Susuki M Yamagishi K Kimura et al. (1996) ArticleTitleFunctional behavior and morphology of the coronary artery wall in patients with Kawasaki disease assessed by intravascular ultrasound J Am Coll Cardiol 27 291–296
M Takahashi W Mason A Lewis (1987) ArticleTitleRegression of coronary aneurysms in patients with Kawasaki syndrome Circulation 75 387–397
K Tatara S Kusakawa (1987) ArticleTitleLong-term prognosis of giant coronary aneurysm in Kawasaki disease: an angiographic study J Pediatr 111 705–710
E Tsuda (2003) ArticleTitleIntravascular ultrasound in Kawasaki disease Res Adv Cardiol . 21–28
E Tsuda T Kamiya K Kimura et al. (2002) ArticleTitleCoronary artery dilatation exceeding 4.0 mm during acute Kawasaki disease predicts a high probability of subsequent late intima-medial thickening Pediatr Cardiol 23 9–14
H Yanagawa Y Nakamura M Yashiro (2002) ArticleTitleResults of the nationwide epidemiologic survey of Kawasaki disease in 1999 and 2000 in Japan J Pediatr Practice 65 332–342
Acknowledgments
We thank all pediatric cardiologists who have belonged to the National Cardiovascular Center since 1978 for their support and cooperation. We thank Professor Peter and Dr. Setsuko Olley for their kind English language consultation.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tsuda, E., Kamiya, T., Ono, Y. et al. Incidence of Stenotic Lesions Predicted by Acute Phase Changes in Coronary Arterial Diameter During Kawasaki Disease. Pediatr Cardiol 26, 73–79 (2005). https://doi.org/10.1007/s00246-004-0698-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00246-004-0698-1