Abstract
The coronary artery lesions in Kawasaki disease (KD) are thought to be a possible risk factor for atherosclerosis in the long term from the pathological point of view. Here we report results of a comparative control study to investigate the distensibility of the coronary artery in KD. A total of 146 patients were divided into 5 groups as follows. (I) Normal group (N) ; consisting of 44 patients with a known history of KD but with no coronary artery lesion. Among this group of patients those who each showed a regression in their coronary artery aneurysms were divided into 2 subgroups according to the time since onset of KD. (II) A group in the early stage after regression (ER) ; consisting of 18 patients with a known history of KD followed for 1.8±0.6 years. (III) A group in the later stage after regression (LR) ; consisting of 22 patients with a known history of KD followed for 9.4±2.8 years. (IV) an abnormal group (A); consisting of 21 patients followed for 7.9±4.0 years with a persistent aneurysm and/or stenosis in a coronary artery at the time of this study. And (V) a control group (C); consisting of 41 patients with a congenital heart disease such as a small ventricular septal defect or mild pulmonary stenosis or patent ductus arteriosus and no history of KD. In each case, the coronaryy artery diameter was measured by angiography before and after intracoronary infusion of isosorbide dinitrate (ISDN). Then, the percent change in the coronary artery diameter was calculated as follows;«(After ISDN-Before ISDN)/Before ISDN×100». The percent changes were 16.168±12.494% (N), 11.622±6.975% (ER), 9.891±9.190% (LR), 6.338±7.723% (A), and 14.561±11.652% (C), respectively. In the A group, there was significantly poorer distensibility compared with C, N, or ER group. And the LR group also demonstrated significantly poorer distensibility compared with the N group (P<0.05). Results of this study suggest that the coronary artery in KD may become stiff not only in the persistent abnormal lesion but also possibly in the regressed aneurysm over the long term. Such stiffness may then constitute a risk factor for atherosclerosis.
