Hostname: page-component-848d4c4894-4hhp2 Total loading time: 0 Render date: 2024-05-11T07:23:58.453Z Has data issue: false hasContentIssue false
  • English
  • Français

Characteristics of coronary flow velocity reserve on transthoracic Doppler echocardiography in patients with a history of Kawasaki disease

Part of: Echocardiography

Published online by Cambridge University Press:  12 November 2021

Etsuko Tsuda Open the ORCID record for Etsuko Tsuda [Opens in a new window]  and
Shuji Hashimoto
Etsuko Tsuda*
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
Shuji Hashimoto
Affiliation:
Department of Physiological Laboratory, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
*
Author for correspondence: E. Tsuda, Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka, Japan. Tel: +81-6170-1070; Fax: +81-6170-1782. E-mail: etsuda@ncvc.go.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Whether the acute inflammation caused by Kawasaki disease will have an effect on the endothelial function of coronary arteries in the future is unknown.

Methods:

The coronary flow velocity reserve of the left anterior descending artery was examined by transthoracic Doppler echocardiography in 189 patients (male 125, female 64) with a history of Kawasaki disease and 10 volunteers (control). Their ages ranged from 6 to 40 years (median 22 years). The patients were divided into nine groups based on the left anterior descending artery lesions. The coronary flow velocity reserve was measured by intravenous administration of adenosine triphosphate (0.15 mg/kg/minute) while fasting. The coronary flow velocity reserve was calculated as the ratio of hyperaemic to basal mean diastolic flow velocities. The respective groups were as follows: control, no coronary artery lesions (n = 39), no coronary artery lesions in the right coronary artery (n = 29), regression (n = 11), aneurysm at the bifurcation of the left coronary artery (n = 26), aneurysm of the left anterior descending artery (n = 15), localised stenosis <75% (n = 12), localised stenosis ≥75% (n = 17), segmental stenosis (n = 5) and coronary artery bypass grafting (n = 36). One-factor ANOVA followed by Tukey’s test was used to compare the coronary flow velocity reserve among the groups.

Results:

The coronary flow velocity reserve was significantly lower in the localised stenosis ≥75%, segmental stenosis and coronary artery grafting groups than in the other groups (p < 0.05).

Conclusions:

The endothelial function in the epicoronary artery was preserved in patients with a history of Kawasaki disease and dilated coronary artery lesions.

Keywords

Coronary flow velocity reservecoronary artery bypass graftingKawasaki disease
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 9 , September 2022 , pp. 1451 - 1455
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Tsuda, E, Tsujii, N, Kimura, K, Suzuki, A. Distribution of Kawasaki disease coronary artery aneurysms and the relationship to coronary artery diameter. Pediatr Cardiol 2017; 38: 932–940.CrossRefGoogle ScholarPubMed
Tsuda, E, Tsujii, N, Hayama, Y. Stenotic lesions and the maximum diameter of coronary artery aneurysms in Kawasaki disease. J Pediatr 2018; 194: 165–170.CrossRefGoogle ScholarPubMed
Tsuda, E, Hashimoto, S. Changes in coronary aneurysm diameters after acute Kawasaki disease from infancy to adolescence. Pediatr Cardiol 2021. In press, 10.1007/s00246-021-02659-1.CrossRefGoogle Scholar
Hozumi, T, Yoshida, K, Ogawa, Y, et al. Noninvasive assessment of significant left anterior descending coronary artery stenosis by coronary flow reserve using transthoracic color Doppler echocardiography. Circulation 1998; 97: 1557–1562.CrossRefGoogle ScholarPubMed
Caiati, C, Montaldo, C, Zedda, N, et al. Validation of a new noninvasive method (contrast-enhanced transthoracic second harmonic echo Doppler) for the evaluation of coronary artery flow reserve: comparison with intracoronary Doppler flow wire. J Am Coll Cardiol 1999; 34: 1193–1200.CrossRefGoogle ScholarPubMed
Cicala, S, Galderisi, M, Grieco, M, Lamberti, A, Cosimi, R, Pellegrini, F, et al. Transthoracic echo-Doppler assessment of coronary microvascular function late after Kawasaki disease. Pediatr Cardiol 2008; 29: 321–327.CrossRefGoogle ScholarPubMed
Gould, KL, Lipscomb, K, Hamilton, GW. Physiologic basis for assessing critical coronary stenosis. Am J Cardiol 1974; 33: 87–94.CrossRefGoogle ScholarPubMed
Tsuda, E, Fujita, H, Yagihara, T, Yamada, O, Echigo, S, Kitamura, S. Competition native flow and graft flow after coronary artery bypass grafting. Impact on indications for coronary artery bypass grafting. Pediatr Cardiol 2008; 29: 266–270.CrossRefGoogle ScholarPubMed
Meimoun, P, Benali, T, Sayah, S, et al. Evaluation of left anterior descending coronary artery stenosis of intermediate severity using transthoracic coronary flow reserve and dobutamine stress echocardiograph. J Am Soc Echocardiogr 2005; 18: 1233–1240.CrossRefGoogle Scholar
Fukazawa, R, Kobayashi, J, Japanese Circulation Society Joint Working Group, et al. JCS/JSCS 2020 Guideline on diagnosis and management of cardiovascular sequelae in Kawasaki disease. Circ J 2020; 84: 1348–1407. DOI 10.1253/circj.CJ-19-1094.CrossRefGoogle ScholarPubMed
Montisci, R, Ruscazio, M, Marchetti, MF, et al. Feasibility, symptoms, adverse effects, and complications associated with noninvasive assessment of coronary flow velocity reserve in women with suspected or known coronary artery disease. Echocardiography 2017; 34: 1324–1331.CrossRefGoogle ScholarPubMed
Auriti, A, Loiaconi, V, Pristipino, C, et al. Recovery of distal coronary flow reserve in LAD and LCX after Y-Graft intervention assessed by transthoracic echocardiography. Cardiovasc Ultrasound 2010; 8: 34.CrossRefGoogle ScholarPubMed
Dionne, A, Ibrahim, R, Gebhard, C, et al. Difference between persistent aneurysm, regressed aneurysm and coronary dilation in Kawasaki disease: an optical coherence tomography study. Can J Cardiol 2018; 34: 1120–1128.CrossRefGoogle Scholar
Tsuda, E, Kamiya, T, Kimura, K, Ono, Y, Echigo, S. Coronary artery dilatation exceeding 4.0mm during acute Kawasaki disease predicts a high probability of subsequent late intima-medial thickening. Pediatr Cardiol 2002; 23: 9–14.CrossRefGoogle Scholar
Vacca, A, Montisci, R, Garau, P, Siotto, P, Piga, M, Alberto, C, et al. Prognostic impact of coronary microcirculation abnormalities in systemic sclerosis: a prospective study to evaluate the role of non-invasive tests. Arthritis. Research & Therapy 2013; 15: R8.CrossRefGoogle ScholarPubMed
Lee, DH, Youn, HJ, Choi, TS, et al. Coronary flow reserve is a comprehensive indicator of cardiovascular risk factors in subjects with chest pain and normal coronary angiogram. Circ J 2010; 74: 1405–1414.CrossRefGoogle ScholarPubMed
Fujiwara, M, Tamura, T, Yoshida, K, et al. Coronary flow reserve in angiographically normal coronary arteries with one-vessel coronary artery disease without traditional risk factors. Eur Heart J 2001; 22: 479–487.CrossRefGoogle ScholarPubMed
Supplementary material: File

Tsuda and Hashimoto supplementary material

Tsuda and Hashimoto supplementary material

Download Tsuda and Hashimoto supplementary material(File)
File 100.4 KB