Background: Positron emission tomography and H2(15)O were used to characterize regional myocardial blood flow and distribution at rest and in response to dipyridamole in children with Kawasaki disease but without angiographic evidence of coronary stenosis.
Method: Patients were classified into two groups on the basis of the results of selective coronary angiography: subjects in group I had normal coronary angiograms (n = 4): subjects in group II had aneurysms (n = 5).
Results: Myocardial perfusion, assessed with H2(15)O, was homogeneous over all regions at rest and at peak flow in groups I and II. Dipyridamole infusion significantly reduced myocardial perfusion reserve in group II (average 3.56 +/- 1.03 fold versus 5.06 +/- 1.37 fold in group I, P < 0.001).
Conclusion: Our results suggest that aneurysms associated with Kawasaki disease may reduce myocardial reserve. Non-invasive quantitative assessment of myocardial blood flow with positron emission tomography and H2(15)O was useful in assessing the functional capacity of coronary artery lesions and the extent of myocardial damage in children with Kawasaki disease.