Analysis of arterial function in adults with a history of Kawasaki disease

Background and purpose: It remains controversial whether Kawasaki disease (KD) is a risk factor for the early onset of atherosclerosis. The purpose of the present study was to assess endothelial function and arterial stiffness as markers of the early onset of atherosclerosis in adult patients with a history of KD. Methods and subjects: We compared 14 adult patients with a history of KD with 41 healthy controls. To assess arterial endothelial function, we measured the reactive hyperemia-peripheral arterial tonometry (RH-PAT) index and augmentation index adjusted to 75 bpm (AIx@75) using the Endo-PAT 2000 (Itamar Medical, Caesarea, Israel). In addition, we analyzed medical history, blood pressure, lifestyle habits, and atherosclerosis-related serum biochemical markers [asymmetric dimethylarginine, adiponectin, lipoprotein (a), cholesterols, atherogenic index of plasma]. Results: There was no difference between the KD and control groups with regard to the RH-PAT index values (2.10 +/- 0.43 and 1.84 +/- 0.49, respectively; p = 0.19). However, in the KD group, the RH-PAT index values were negatively correlated with the febrile period in the acute phase of disease (r(2) = 0.458, p = 0.048). In addition, the AIx@75 values were higher in KD patients compared to healthy controls (-7.69 +/- 11.86% and -15.87 +/- 8.72%, respectively; p = 0.01). No significant differences existed between the KD and control groups with regard to the serum biomarkers of atherosclerosis. Conclusions: We speculate that endothelial dysfunction in former KD patients is affected by the febrile period of the acute phase, and antiplatelet drugs may improve endothelial function. The increased arterial stiffness of patients caused by post-inflammatory fibrotic changes in the arterial wall indicates that adults with a history of KD have an increased risk of developing atherosclerosis. (c) 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.