The Significance of Early Subtle Coronary Arterial Lesions on Echocardiogram in Kawasaki Disease

急性期川崎病超音波心圖之細微冠狀動脈病變之意義

張正成(Jeng-Sheng Chang) ； 蔡長海(Chang-Hai Tsai) ； 吳美環(Mei-Hwan Wu) ； 王主科(Jou-Kou Wang)

《Acta Paediatrica Sinica》 40卷2期 (1999/04) Pp. 101-106

https://doi.org/10.7097/APS.199904.0151

摘要

Intensive echocardiographic studies were undertaken in 37 patients with Kawasaki disease (KD) and 12 febrile controls during the acute stages. Video-tape recordings were read doubly-blinded by 3 pediatric cardiologists at 2 hospitals. Three characteristics of subtle coronary arterial lesions, including contour of lumen, smoothness of endothelium and sono-homogeneily of the surrounding tissue were particularly described. Seven of the 37 KD patients (19%) were found to have coronary arterial aneurysms (CAA) at the end of the convalescent stage. The 3 cardiologists agreed in the diagnosis of the subtle lesions by 72%. More patients with Kawasaki disease were found to have an irregular endothelium than the controls (P＜0.001). KD patients later complicated with CAA were more likely to have had the three characteristics of subtle coronary lesions during the acute stage than the KD patients without aneurysms (P＜0.001). Also, the coronary arterial size measured during the acute stage were found to be positively correlated with their largest dilatation at the convalescent stage (P=0.0001, γ=0.61). We conclude that early subtle coronary arterial lesions can herald the development of coronary arterial aneurysms.

關鍵字

川崎病 ； 冠狀動脈瘤 ； 心臓超音波 ； 血管炎

並列摘要

Intensive echocardiographic studies were undertaken in 37 patients with Kawasaki disease (KD) and 12 febrile controls during the acute stages. Video-tape recordings were read doubly-blinded by 3 pediatric cardiologists at 2 hospitals. Three characteristics of subtle coronary arterial lesions, including contour of lumen, smoothness of endothelium and sono-homogeneily of the surrounding tissue were particularly described. Seven of the 37 KD patients (19%) were found to have coronary arterial aneurysms (CAA) at the end of the convalescent stage. The 3 cardiologists agreed in the diagnosis of the subtle lesions by 72%. More patients with Kawasaki disease were found to have an irregular endothelium than the controls (P＜0.001). KD patients later complicated with CAA were more likely to have had the three characteristics of subtle coronary lesions during the acute stage than the KD patients without aneurysms (P＜0.001). Also, the coronary arterial size measured during the acute stage were found to be positively correlated with their largest dilatation at the convalescent stage (P=0.0001, γ=0.61). We conclude that early subtle coronary arterial lesions can herald the development of coronary arterial aneurysms.

並列關鍵字

kawasaki disease ； coronary arterial aneurysm ； echocardiography ； vasculitis