Relationship between carotid intima-media thickness and arterial stiffness in children after Kawasaki disease

YF Cheung ^1*, Sophia J Wong ² and Marco HK Ho ²

¹ Division of Paediatric Cardiology, Hong Kong
² The University of Hong Kong, Hong Kong

^* To whom correspondence should be addressed. E-mail: xfcheung{at}hkucc.hku.hk.

Accepted 26 June 2006

Abstract

Background:Evidence of premature atherosclerosis and systemic arterial stiffening in patients after Kawasaki disease (KD) is accumulating.

Aim:To test the hypothesis that carotid intima- media thickness (IMT), a surrogate marker of atherosclerosis, is associated with systemic arterial stiffness in children after KD.

Methods:A cohort of 72 subjects was studied, comprising 26 KD patients with coronary aneurysms (group I), 24 KD patients with normal coronary arteries (group II) and 22 healthy age-matched children (group III). The carotid intima-media thickness (IMT), carotid artery stiffness index, brachioradial pulse wave velocity (PWV), fasting total cholesterol, HDL cholesterol, and LDL cholesterol were determined and compared among the 3 groups.

Results: The carotid IMT was related to indices of arterial stiffness, and significant determinants of carotid IMT identified by multivariate analysis. The carotid IMT of both group I (0.41±0.04 mm) and group II (0.39±0.04 mm) was significantly greater than that of group III (0.36±0.04 mm) (p<0.001 and p=0.008, respectively). For the entire cohort, carotid IMT correlated positively with LDL cholesterol (r=0.31, p=0.009), carotid artery stiffness index (r=0.40, p=0.001) and brachioradial PWV (r=0.28, p=0.016), but not with age, body mass index, systemic blood pressure, and HDL and total cholesterol. Multiple linear regression analysis identified carotid artery stiffness index (=0.25, p=0.028) and subject grouping (=-0.39, p=0.001) (model R2=0.29) as significant determinants of carotid IMT.

Conclusion:The increased carotid IMT in children after KD is associated with systemic arterial stiffening.

Keywords: Kawasaki disease, arterial stiffness, intim-media thickness

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