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Background: Accurate classification of coronary artery abnormalities (CAAs) is essential for clinical decision‐making and long‐term management in Kawasaki disease (KD) patients. To date, there are several echocardiographic criteria of CAA assessment. Materials and methods: The Japanese Ministry of Health (JMH) criteria and the Z‐score criteria from 2004 American Heart Association guidelines were adopted and their detective efficacies for CAAs were compared in 251 Chinese patients with KD Z scores were calculated by 6 published methods. Results: According to the JMH criteria, 19 (7.57%) KD patients were classified as CAAs during the acute KD episode. However, the detective number of CAAs was highest and had a 0.68‐fold increase by the Dallaire et al method with a Z‐score cut point of ≥2.5 as compared with the JMH criteria; in contrast, more than 78.95% of patients with CAAs identified by the JMH criteria had a coronary artery Z score ≥2.5. All 6 different Z‐score methods had satisfactory accuracies with a range from 93.23% to 97.61% in screening CAAs. For the 19 patients with CAAs identified by the JMH criteria, their Z scores presented the widest variation calculated by the McCrindle et al method. Conclusions: The JMH criteria underestimate the prevalence of CAAs as compared with the Z‐score criteria. Quantitative assessment of coronary artery luminal dimensions, normalized as Z scores adjusted for body surface, should be recommended. The larger coronary artery luminal dimensions vary, the more heterogeneous Z scores calculated by different methods have. [ABSTRACT FROM AUTHOR]

Background: Kawasaki disease (KD) is an acute, self‐limited vasculitis. Coronary artery aneurysm (CAA) serves as a major contributor to the long‐term prognosis of KD. In addition, acute KD usually also leads to several kinds of noncoronary cardiac abnormalities (NCA) involving the pericardium, myocardium and endocardium. Materials and methods: A total of 142 Chinese children with KD were recruited from July 2015 to April 2018. Blood samples were collected at 24 hours pre‐intravenous immunoglobulin (IVIG) therapy. Several inflammatory mediators and biomarkers for acute myocardial infarction were detected. Echocardiography and electrocardiography (ECG) were performed. Results: Plasma white blood cell counts (WBC) were significantly increased in patients with IVIG‐nonresponsive KD when compared with their IVIG‐responsive counterparts. A total of 106 children (74.65%) suffered from NCA, including 8 patients (5.63%) with pericardial effusion, 23 patients (16.20%) with acute myocarditis, 101 patients (71.13%) with valvular regurgitation and 8 patients (5.63%) with abnormal ECG. No significant differences were observed in the distribution of clinical classification and the response to IVIG therapy regardless of NCA exhibited or not. Conclusions: Noncoronary cardiac abnormalities is almost universal in acute KD and mainly manifests as valvular regurgitation. However, it has no influence on clinical classification and the response to IVIG therapy. [ABSTRACT FROM AUTHOR]