Background and aim Kawasaki disease (KD) is a generalised systemic vasculitis of unknown aetiology involving medium and small size blood vessels, particularly the coronary arteries, in which a progressive stenosis may result from active remodelling with an intimal proliferation and neoangiogenesis. The aim of our study was to assess if subjects with a previous diagnosis of KD show, after several years, a coronary intimal thickening, suggestive of a persistent cardiovascular risk, by using high-resolution transthoracic echocardiography (HRTE).
Methods We conducted an observational cross-sectional case-control double-blind study on 21 patients with a previous diagnosis of KD who had been hospitalised, as children, since January 1990 to December 1999 in our Paediatric Department of the University of Catania, Italy. We performed colordoppler-echocardiography in all patients assessing measurement of thickening, inner diameter and outer diameter of proximal portion of left coronary artery using HRTE.
The cardiologic data were compared with those of the 21 healthy subjects of the same age.
Results We found a significant intimal thickening in patients with previous KD compared to healthy controls (3.9 mm ± 2.4 mm vs 1.8 mm ± 0.6 mm p < 0.05). In particular, we noticed that also subjects not suffering from coronary impairment in acute phase have higher values of thickening than healthy controls, configuring a higher cardiovascular risk.
Conclusions We concluded that the assessment of coronary artery thickening by means of HRTE may become an essential instrument to evaluate late cardiovascular risk in subjects with a diagnosis of KD in childhood.