Abstract 16234: Galectin-3 Levels in Young Adults With a History of Kawasaki Disease
Background: Kawasaki disease (KD) is an acute, self-limited vasculitis of unknown etiology that occurs in young children. Up to 25% of untreated and 5% of treated patients develop coronary aneurysms; a subset develop other cardiovascular (CV) sequelae. Galectin-3 (Gal3) is a novel marker of cardiac fibrosis that is associated with incident heart failure and mortality in patients with CV disease, but its association with CV sequelae late after KD is unknown.
Methods: We enrolled 86 young adults with a childhood history of KD, and 60 age- and sex- matched controls. Clinical information and blood samples were collected at time of enrollment. KD subjects were classified based upon coronary artery status (normal, dilated, aneurysm).
Results: Mean age at enrollment was 25 years and was similar in KD subjects and controls. Mean time since KD onset was 20 years, and was not significantly correlated with Gal3 levels. KD subjects overall had higher median Gal3 levels than controls (10.7 vs 9.2 ng/mL, p=0.047). Among KD subjects, Gal3 levels varied by coronary artery status (p=0.03). Median Gal3 levels were higher in the 21 KD patients with coronary aneurysms (13.3 ng/mL) compared to control subjects (p=0.01), and compared to the 59 KD subjects with normal coronary arteries (10.0 ng/mL, p=0.049). Gal3 levels were highest in the 5 KD subjects with giant aneurysms (Figure ). KD subjects with normal coronary arteries did not have significantly higher Gal3 levels than controls.
Conclusion: Young adults with a history of KD and coronary aneurysms have significantly higher Gal3 levels compared to those without aneurysms and to controls. Gal3 influences the TGF-β pathway and endothelial-mesenchymal transition (EMT); the TGF-β pathway and EMT are important in KD pathogenesis. Thus, higher Gal3 levels may identify a phenotype of individuals at higher risk for developing aneurysms in the setting of KD. Prospective studies will help clarify the relationship between Gal3 and CV sequelae of KD.
- © 2013 by American Heart Association, Inc.