Abstract 17654: Late Wall Thickening and Calcification in Patients After Kawasaki Disease Noninvasively Detected by Dual Source Computed Tomography
Background: Late coronary wall thickening (WT) including coronary calcification indicates an irreversible change of the coronary artery after Kawasaki disease (KD), which can be detected noninvasively by Dual Source Computed Tomography (DSCT).
Purpose: We retrospectively investigated the relation between coronary artery lesion (CAL) in the acute KD and late WT detected by DSCT.
Methods: Sixty-two pts (47 males and 15 females) who had previously undergone selective coronary angiograms (CAGs) less than 100 days after the onset of KD were studied by DSCT. The age at DSCT ranged from 10 months to 36 years (median, 18 years). The interval from the onset of KD to DSCT ranged from 26 days to 34 years (median, 16 years). DSCT was performed using a SOMATOM® Definition Flash (Siemens). The maximum diameters of segments 1, 2, 3, 6, 7, and 11 were measured in the initial CAGs (Branches group; BG), and the bifurcation of the left coronary artery was also measured (LCA). WT was diagnosed by two observers. We studied the relationship between the maximum diameter of coronary artery detected by the initial CAG, the interval from the onset of KD and the appearance of WT detected by DSCT. We determined the cut-off point of coronary artery dilatation for WT in each group by using Receiver Operating Characteristic (ROC) analysis.
Results: WT in the BG and the LCA were detected in 119/326 and 24/39, respectively. The appearance of late WT in CAL of acute phase was 115/190 (61%), and that in no CAL was 4/136 (3%) (p<0.001) in the BG group. In both groups, the appearance of WT was significantly related with the initial diameters and the interval from onset of KD, respectively. The cut-off point of acute coronary dilatation for WT in BG was 4.8mm (AUC 0.86, p<0.0001), and that in LCA was 7.9 mm (AUC 0.65, p=0.0464).
Conclusions: Acute coronary dilatation more than 4.8 mm in BG and 7.9 mm in LCA can lead to late WT. DSCT was useful to detect late WT in patients after KD.
- Kawasaki disease
- Computed tomography
- CT angiography
- Coronary vessels
- Coronary artery calcification (CAC)
Author Disclosures: N. Tsujii: None. E. Tsuda: None. S. Kanzaki: None. J. Ishizuka: None. K. Nakashima: None. K. Kurosaki: None.
- © 2014 by American Heart Association, Inc.