Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2021

Open Access 01-12-2021 | Aneurysm | Research

Intimal thickening and disruption of the media occur in the arterial walls of coronary arteries not associated with coronary arterial aneurysms in patients with Kawasaki disease

Authors: Tomoya Tsuchihashi, Nobuyuki Kakimoto, Takashi Takeuchi, Tomohiro Suenaga, Takayuki Suzuki, Shoichi Shibuta, Yasushi Ino, Takashi Kubo, Takashi Akasaka, Hiroyuki Suzuki

Published in: BMC Cardiovascular Disorders | Issue 1/2021

Login to get access

Abstract

Background

Coronary artery aneurysm (CAA) is an important complication of Kawasaki disease (KD) that is associated with arterial structure damage. However, few studies have examined structural changes in coronary arteries that are not associated with CAA.

Methods

We examined coronary arteries in KD patients with CAAs who underwent follow-up coronary angiography (CAG) and optical coherence tomography (OCT). Coronary arterial branches with no abnormal findings during the most recent CAG were classified into two groups. Arteries with an acute-phase CAA that later regressed were classified as group R; arteries with no abnormal findings on either acute or convalescent phase CAG were classified as group N. Coronary arterial wall structural changes were compared between groups using OCT.

Results

Fifty-seven coronary arterial branches in 23 patients were evaluated by OCT. Thirty-six branches showed no abnormality during the most recent CAG. Both groups R and N comprised 18 branches. Maximum intimal thicknesses in groups R and N were 475 and 355 µm, respectively (p = 0.007). The incidences of media disruption were 100% and 67%, respectively (p = 0.02). Calcification, macrophage accumulation, and thrombus were not found in either group.

Conclusions

Intimal thickening and disruption of the media occur in coronary arteries with acute phase CAAs that later regress in the convalescent phase, as well as in arteries with normal CAG findings in the acute and convalescent phases.
Literature
1.
go back to reference Kobayashi T, Saji T, Otani T, et al. Efficacy of immunoglobulin plus prednisolone for prevention of coronary artery abnormalities in severe Kawasaki disease (RAISE study): a randomized, open-label, blinded-endpoints trial. Lancet. 2012;379:1613–20.CrossRef Kobayashi T, Saji T, Otani T, et al. Efficacy of immunoglobulin plus prednisolone for prevention of coronary artery abnormalities in severe Kawasaki disease (RAISE study): a randomized, open-label, blinded-endpoints trial. Lancet. 2012;379:1613–20.CrossRef
2.
go back to reference Burns JC, Best BM, Mejias A, et al. Infliximab treatment of intravenous immunoglobulin-resistant Kawasaki disease. J Pediatr. 2008;153:833–8.CrossRef Burns JC, Best BM, Mejias A, et al. Infliximab treatment of intravenous immunoglobulin-resistant Kawasaki disease. J Pediatr. 2008;153:833–8.CrossRef
3.
go back to reference Hamada H, Suzuki H, Onouchi Y, et al. Efficacy of primary treatment with immunoglobulin plus ciclosporin for prevention of coronary artery abnormalities in patients with Kawasaki disease predicted to be at increased risk of non-response to intravenous immunoglobulin (KAICA): a randomised controlled, open-label, blinded-endpoints, phase 3 trial. Lancet. 2019;393:1128–37.CrossRef Hamada H, Suzuki H, Onouchi Y, et al. Efficacy of primary treatment with immunoglobulin plus ciclosporin for prevention of coronary artery abnormalities in patients with Kawasaki disease predicted to be at increased risk of non-response to intravenous immunoglobulin (KAICA): a randomised controlled, open-label, blinded-endpoints, phase 3 trial. Lancet. 2019;393:1128–37.CrossRef
4.
go back to reference Ae R, Makino N, Kosami K, Kuwabara M, Matsubara Y, Nakamura Y. Epidemiology, treatments, and cardiac complications in patients with Kawasaki disease: the nationwide survey in Japan, 2017–2018. J Pediatr. 2020;225:23–9.CrossRef Ae R, Makino N, Kosami K, Kuwabara M, Matsubara Y, Nakamura Y. Epidemiology, treatments, and cardiac complications in patients with Kawasaki disease: the nationwide survey in Japan, 2017–2018. J Pediatr. 2020;225:23–9.CrossRef
5.
go back to reference Takahashi K, Oharaseki T, Naoe S. Pathological Study of postcoronary arteritis in adolescents and young adults: with reference to the relationship between sequelae of Kawasaki disease and atherosclerosis. Pediatr Cardiol. 2001;22:138–42.CrossRef Takahashi K, Oharaseki T, Naoe S. Pathological Study of postcoronary arteritis in adolescents and young adults: with reference to the relationship between sequelae of Kawasaki disease and atherosclerosis. Pediatr Cardiol. 2001;22:138–42.CrossRef
6.
go back to reference Takahashi K, Oharaseki T, Yokouchi Y, Naoe S, Saji T. Kawasaki disease: basic and pathological findings. Clin Exp Nephrol. 2013;17:690–3.CrossRef Takahashi K, Oharaseki T, Yokouchi Y, Naoe S, Saji T. Kawasaki disease: basic and pathological findings. Clin Exp Nephrol. 2013;17:690–3.CrossRef
7.
go back to reference Tsuda E, Kamiya T, Kimura K, Ono Y, Echigo S. Coronary artery dilatation exceeding 4.0 mm during acute Kawasaki disease predicts a high probability of subsequent late intima-medial thickening. Pediatr Cardiol. 2002;23:9–14.CrossRef Tsuda E, Kamiya T, Kimura K, Ono Y, Echigo S. Coronary artery dilatation exceeding 4.0 mm during acute Kawasaki disease predicts a high probability of subsequent late intima-medial thickening. Pediatr Cardiol. 2002;23:9–14.CrossRef
8.
go back to reference Kakimoto N, Suzuki H, Kubo T, et al. Evaluation of coronary arterial lesions due to Kawasaki disease using optical coherence tomography. Can J Cardiol. 2014;956:e7–9. Kakimoto N, Suzuki H, Kubo T, et al. Evaluation of coronary arterial lesions due to Kawasaki disease using optical coherence tomography. Can J Cardiol. 2014;956:e7–9.
11.
go back to reference Akasaka T, Kubo T, Mizukoshi M, et al. Pathophysiology of acute coronary syndrome assessed by optical coherence tomography. J Cardiol. 2010;56:8–14.CrossRef Akasaka T, Kubo T, Mizukoshi M, et al. Pathophysiology of acute coronary syndrome assessed by optical coherence tomography. J Cardiol. 2010;56:8–14.CrossRef
12.
go back to reference Fujino Y, Attizzani GF, Tahara S, et al. Frequency-domain optical coherence tomography evaluation of a patient with Kawasaki disease and severely calcified plaque. Int J Cardiol. 2014;171:281–3.CrossRef Fujino Y, Attizzani GF, Tahara S, et al. Frequency-domain optical coherence tomography evaluation of a patient with Kawasaki disease and severely calcified plaque. Int J Cardiol. 2014;171:281–3.CrossRef
13.
go back to reference Kamiya T, Kawasaki T, Okuni M, et al. Subcommittee for standardization of diagnosing coronary artery lesion in patients with Kawasaki disease. Research Committee for Kawasaki Disease in the Ministry of Welfare and Health. Diagnostic criteria of cardiovascular complication after Kawasaki disease. 1983:1–10. http://www.niph.go.jp/wadai/mhlw/1983/s5805004.pdf (in Japanese). Kamiya T, Kawasaki T, Okuni M, et al. Subcommittee for standardization of diagnosing coronary artery lesion in patients with Kawasaki disease. Research Committee for Kawasaki Disease in the Ministry of Welfare and Health. Diagnostic criteria of cardiovascular complication after Kawasaki disease. 1983:1–10. http://​www.​niph.​go.​jp/​wadai/​mhlw/​1983/​s5805004.​pdf (in Japanese).
14.
go back to reference JCS Joint Working Group. Guidelines for diagnosis and management of cardiovascular sequelae in Kawasaki disease (JCS 2013). Circ J. 2014;78:2521–62.CrossRef JCS Joint Working Group. Guidelines for diagnosis and management of cardiovascular sequelae in Kawasaki disease (JCS 2013). Circ J. 2014;78:2521–62.CrossRef
15.
go back to reference McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 2017;135:e927-999.CrossRef McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 2017;135:e927-999.CrossRef
16.
go back to reference Goar FG, Pinto FJ, Alderman EL, et al. Detection of coronary atherosclerosis in young adult hearts using intravascular ultrasound. Circulation. 1992;86:756–63.CrossRef Goar FG, Pinto FJ, Alderman EL, et al. Detection of coronary atherosclerosis in young adult hearts using intravascular ultrasound. Circulation. 1992;86:756–63.CrossRef
17.
go back to reference Suzuki A, Tsuda E, Fujiwara M, Arakaki Y, Ono Y, Kamiya T. Observation of coronary arterial lesion due to Kawasaki disease in the late phase by intravascular ultrasound. Prog Med. 1996;16:1797–800. Suzuki A, Tsuda E, Fujiwara M, Arakaki Y, Ono Y, Kamiya T. Observation of coronary arterial lesion due to Kawasaki disease in the late phase by intravascular ultrasound. Prog Med. 1996;16:1797–800.
18.
go back to reference Kume T, Akasaka T, Kawamoto T, et al. Assessment of coronary intima—media thickness by optical coherence tomography comparison with intravascular ultrasound. Circ J. 2005;69:903–7.CrossRef Kume T, Akasaka T, Kawamoto T, et al. Assessment of coronary intima—media thickness by optical coherence tomography comparison with intravascular ultrasound. Circ J. 2005;69:903–7.CrossRef
19.
go back to reference Tearney GJ, Regar E, Akasaka T, et al. Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies. J Am Coll Cardiol. 2012;59:1058–72.CrossRef Tearney GJ, Regar E, Akasaka T, et al. Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies. J Am Coll Cardiol. 2012;59:1058–72.CrossRef
20.
go back to reference Shimizu C, Sood A, Lau HD, et al. Cardiovascular pathology in 2 young adults with sudden, unexpected death due to coronary aneurysms from Kawasaki disease in childhood. Cardiovasc Pathol. 2015;24:310–6.CrossRef Shimizu C, Sood A, Lau HD, et al. Cardiovascular pathology in 2 young adults with sudden, unexpected death due to coronary aneurysms from Kawasaki disease in childhood. Cardiovasc Pathol. 2015;24:310–6.CrossRef
21.
go back to reference Iemura M, Ishii M, Sugimura T, Akagi T, Kato H. Long term consequences of regressed coronary aneurysms after Kawasaki disease: vascular wall morphology and function. Heart. 2000;83:307–11.CrossRef Iemura M, Ishii M, Sugimura T, Akagi T, Kato H. Long term consequences of regressed coronary aneurysms after Kawasaki disease: vascular wall morphology and function. Heart. 2000;83:307–11.CrossRef
22.
go back to reference Takahashi K, Oharaseki T, Naoe S, Wakayama M, Yokouchi Y. Neutrophilic involvement in the damage to coronary arteries in acute stage of Kawasaki disease. Pediatr Int. 2005;47:305–10.CrossRef Takahashi K, Oharaseki T, Naoe S, Wakayama M, Yokouchi Y. Neutrophilic involvement in the damage to coronary arteries in acute stage of Kawasaki disease. Pediatr Int. 2005;47:305–10.CrossRef
23.
go back to reference Suzuki A, Miyagawa-Tomota S, Komatsu K, Nakazawa M, Fukaya T, Baba K, Yutani C. Immunohistochemical study of apparently intact coronary artery in a child after Kawasaki disease. Pediatr Int. 2004;46:590–6.CrossRef Suzuki A, Miyagawa-Tomota S, Komatsu K, Nakazawa M, Fukaya T, Baba K, Yutani C. Immunohistochemical study of apparently intact coronary artery in a child after Kawasaki disease. Pediatr Int. 2004;46:590–6.CrossRef
24.
go back to reference Holve TJ, Patel A, Chau Q, Marks AR, Meadows A, Zaroff JG. Long-term cardiovascular outcomes in survivors of Kawasaki disease. Pediatrics. 2014;133:305–11.CrossRef Holve TJ, Patel A, Chau Q, Marks AR, Meadows A, Zaroff JG. Long-term cardiovascular outcomes in survivors of Kawasaki disease. Pediatrics. 2014;133:305–11.CrossRef
25.
go back to reference Kawai H, Takakuwa Y, Naruse H, et al. Two cases with past Kawasaki disease developing acute myocardial infarction in their thirties, despite being regarded as at low risk for coronary events. Heart Vessels. 2015;30:549–53.CrossRef Kawai H, Takakuwa Y, Naruse H, et al. Two cases with past Kawasaki disease developing acute myocardial infarction in their thirties, despite being regarded as at low risk for coronary events. Heart Vessels. 2015;30:549–53.CrossRef
26.
go back to reference Shah V, Christov G, Mukasa T, et al. Cardiovascular status after Kawasaki disease in the UK. Heart. 2015;101:1646–55.CrossRef Shah V, Christov G, Mukasa T, et al. Cardiovascular status after Kawasaki disease in the UK. Heart. 2015;101:1646–55.CrossRef
28.
go back to reference Chen KY, Zannino D, Curtis N, Cheung M, Burgner D. Increased aortic intima-media thickness following Kawasaki disease. Atherosclerosis. 2017;260:75–80.CrossRef Chen KY, Zannino D, Curtis N, Cheung M, Burgner D. Increased aortic intima-media thickness following Kawasaki disease. Atherosclerosis. 2017;260:75–80.CrossRef
Metadata
Title
Intimal thickening and disruption of the media occur in the arterial walls of coronary arteries not associated with coronary arterial aneurysms in patients with Kawasaki disease
Authors
Tomoya Tsuchihashi
Nobuyuki Kakimoto
Takashi Takeuchi
Tomohiro Suenaga
Takayuki Suzuki
Shoichi Shibuta
Yasushi Ino
Takashi Kubo
Takashi Akasaka
Hiroyuki Suzuki
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2021
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-021-02090-7

Other articles of this Issue 1/2021

BMC Cardiovascular Disorders 1/2021 Go to the issue