Coronary Artery Dilatation Exceeding 4.0 mm During Acute Kawasaki Disease Predicts a High Probability of Subsequent Late Intima-Medial Thickening

Byline: E. Tsuda (), T. Kamiya (), K. Kimura (), Y. Ono (), S. Echigo () Abstract: We used intravascular ultrasound (IVUS) to compare the degree of coronary artery dilatation during the acute phase of Kawasaki disease with the extent of intima-medial thickening more than 10 years later. We wanted to determine if there was a threshold degree of dilatation that was highly predictive of later thickening. Twenty-eight patients with a mean age of 17.3 +- 1.7 years were studied the mean interval from the initial selective coronary angiography to the IVUS study was 15.0 +- 1.6 years. We measured the maximum intima-medial thickness of selected coronary arterial segments in IVUS images and measured the largest diameters of the corresponding coronary arterial segments in the initial coronary angiograms. A significant correlation was found between the initial diameters of the coronary arteries and the intima-medial thickness more than 10 years later in the right coronary, the left anterior descending coronary, and the left circumflex arteries. The coefficient of correlation was 0.77 (n = 120, p &lt 0.0001), and for the bifurcation of the left coronary artery it was 0.50 (n = 26, p &lt 0.01). For this study, abnormal intima-medial thickness was defined as more than 0.40 mm. When the initial coronary arterial dilatation exceeded 4.0 mm, the sensitivity was 28/31 (90%) and the specificity was 87/89 (98%) in the right coronary, the left anterior descending coronary, and the left circumflex arteries. For the bifurcation of the left coronary artery, the sensitivity was 14/21 (67%) and the specificity was 5/5 (100%). Author Affiliation: () Department of Pediatrics, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita-shi, Osaka 565-8565, Japan, JP () Department of Radiology, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita-shi, Osaka 565-8565, Japan, JP