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Endothelial dysfunction in adult patients with a history of Kawasaki disease

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Abstract

To assess the existence of endothelial dysfunction and the possibility of the early onset of atherosclerosis in the chronic stage of Kawasaki disease (KD), we examined endothelial function in adult patients late after the onset of KD. We evaluated two age-matched groups: 35 adult KD patients (KD group) (mean age, 27.0 years; mean interval time, 24.1 years), and 36 healthy adults (control group). To assess vascular endothelial function, flow-mediated dilatation (%FMD) of the brachial artery and urinary nitrites and nitrates (NOx) were examined. We also measured adhesion molecules and several coagulation-fibrinolysis markers. In addition, we measured high-sensitive C-reactive protein (hs-CRP) as a chronic inflammatory marker, and brachial-ankle pulse wave velocity (baPWV) as a marker for arterial stiffness. %FMD was significantly reduced in the KD group when compared with that of the control group (KD group, 10.4 ± 2.6%; control group, 14.4 ± 3.2%, p<0.05), particularly in patients with coronary artery lesions. Thrombin-antithrombin III complex values were higher in the KD group, although no significant differences were observed in the other markers for endothelial function. Hs-CRP was significantly elevated only in the patients with coronary aneurysms. Furthermore, in the male KD patients, the baPWV values were significantly higher than those in the control subjects. This study revealed that the adult patients with a history of KD had systemic vascular endothelial dysfunction, and also suggested that a history of KD was possibly one of the risk factors for early onset of atherosclerosis.

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Abbreviations

KD:

kawasaki disease

CALs:

coronary artery lesions

%FMD:

Flow-mediated dilatation

ISDN:

Isosorbide dinitrite

%EID:

Endothelium-independent dilatation

SBP:

systemic blood pressure

DBP:

diastolic blood pressure

Cre:

Creatinine

NOx:

Nitrites and nitrates

sICAM-1:

Soluble intercellular adhesion molecule-1

sVCAM-1:

Soluble vascular adhesion molecule-1

TAT:

Thrombin-antithrombin III complex

tPA PAI-1:

Tissue plasminogen activator-plasminogen activator inhibitor-1 complex

vWV:

Von Willebrand factor

hs-CRP:

high-sensitive C-reactive protein

BMI:

body mass index

TC:

total cholesterol

HDL-C:

High-density lipoprotein cholesterol

LDL-C:

Low-density lipoprotein cholesterol

TG:

Triglyceride

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Authors and Affiliations

  1. Department of Pediatric Cardiology and Nephrology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan

    Ayumi Niboshi, Kenji Hamaoka & Koichi Sakata

  2. Department of Environmental Systems Science, Faculty of Engineering, Doshisha University, Kyoto, Japan

    Nozomi Yamaguchi

  3. Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Ayumi Niboshi

Authors
  1. Ayumi Niboshi
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  2. Kenji Hamaoka
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  3. Koichi Sakata
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  4. Nozomi Yamaguchi
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Correspondence to Ayumi Niboshi.

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Niboshi, A., Hamaoka, K., Sakata, K. et al. Endothelial dysfunction in adult patients with a history of Kawasaki disease. Eur J Pediatr 167, 189–196 (2008). https://doi.org/10.1007/s00431-007-0452-9

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  • DOI: https://doi.org/10.1007/s00431-007-0452-9

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