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Coronary arterial abnormalities detected in children over 10 years following initial Kawasaki disease using cardiac computed tomography

Part of: Advanced Imaging

Published online by Cambridge University Press:  28 January 2021

Rajkumar Chakraborty ,
Manphool Singhal Open the ORCID record for Manphool Singhal [Opens in a new window] ,
Vignesh Pandiarajan ,
Avinash Sharma ,
Rakesh K. Pilania  and
Surjit Singh
Rajkumar Chakraborty
Affiliation:
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Manphool Singhal*
Affiliation:
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Vignesh Pandiarajan
Affiliation:
Allergy Immunology Unit, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Avinash Sharma
Affiliation:
Allergy Immunology Unit, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Rakesh K. Pilania
Affiliation:
Allergy Immunology Unit, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Surjit Singh
Affiliation:
Allergy Immunology Unit, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
*
Author for correspondence: Manphool Singhal, Additional Professor, Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India. E-mail: [email protected]
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Abstract

Objective:

To evaluate whether Kawasaki disease predisposes to premature atherosclerosis and to assess status of coronary artery abnormalities at least 10 years after diagnosis.

Material and methods:

A prospective study was carried out on 21 patients who were diagnosed with Kawasaki disease at least 10 years back and are on regular follow-up. The study was conducted on 128 Slice Dual Source computed tomography scanner with electrocardiography-triggered radiation optimised protocols for assessment of coronary artery abnormalities and calcifications.

Results:

Study cohort had 21 subjects – 15 males and 6 females (age range: 11–23 years; mean: 15.76 + 3.72 years). Mean age at time of diagnosis was 3.21 + 2.48 years. Mean time interval from diagnosis of Kawasaki disease to computed tomography coronary angiography was 12.59 + 2.89 years. Four children had evidence of coronary artery abnormalities on transthoracic echocardiography at time of diagnosis. Of these, two had persistent abnormalities on computed tomography coronary angiography. One subject (4.76%) had coronary calcification that was localised to abnormal coronary artery segment. Four coronary artery abnormalities (one saccular; three fusiform aneurysms) were noted in two subjects.

Conclusion:

Prevalence of coronary artery calcification is low and, if present, is localised to abnormal segments. This calcification is likely dystrophic rather than atherosclerotic. It appears that coronary artery abnormalities can persist for several years after acute episode of Kawasaki disease. Periodic follow-up by computed tomography coronary angiography is now a feasible non-invasive imaging modality for long term surveillance of patients with Kawasaki disease who had coronary artery abnormalities at time of diagnosis.

Keywords

Kawasaki diseaseatherosclerosiscoronary artery abnormalitiesCT coronary angiography
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 6 , June 2021 , pp. 998 - 1002
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Rajkumar Chakraborty and Manphool Singhal contributed equally to work and share first authorship.

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