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Abstract
Purpose
We recently reported that children and adolescents with a history of Kawasaki disease (KD) had slight but significant elastic arterial stiffness even when no coronary artery lesions (CALs) were present. Moreover, we hypothesized that KD-related arteriopathy may also cause peripheral artery dysfunction. The objective of this study was to assess the involvement of radial artery pulse waves, especially reflection waves from the peripheral arteries using the radial artery augmentation index (rAI) in patients without CALs after KD.
Materials and methods
We first collected the rAI data from 312 subjects (149 consecutive patients of KD and 163 control subjects). Next, 225 cases between 6 and 15 years old were selected. Finally, 41 pairs were included for analysis. The rAI values of these two groups were compared and analyzed. Acute-phase data were also collected to reveal the possible correlation with rAI in the convalescent period.
Results
Multivariable analysis revealed the history of KD was positively correlated with rAI@75 value in children from 6 to 15 years old. After pairing the height and gender, the KD group also had significantly higher rAI and rAI@75 than the control group (rAI 60.63±13.77 vs 54.56±13.17, p=0.028; rAI@75 63.61±15.21 vs 55.68±14.86, p=0.003). With regard to acute-phase condition, nonresponse to initial treatment was also linked to elevated rAI during the convalescent period.
Conclusions
During the convalescent period, the rAI increased in KD patients without acute CALs. Furthermore, nonresponse to initial treatment in acute phase conferred higher rAI to KD subjects than respondent cases. Elevated rAI means the reflection wave from the peripheral vascular is stronger or earlier. This small but significant change may indicate the existence of peripheral artery stiffness during the convalescent period.
Abbreviation list
BW, body weight; HT, height; HR, heart rate; BP, blood pressure; BMI, body mass index; BSA, body surface area; KD, Kawasaki disease; IVIG, intravenous immunoglobulin; WBC, white blood cell; CRP, C-reactive protein; CALs, coronary artery lesions; rAI, radial artery augmentation index; rAI@75, radial augmentation index adjusted to heart rate 75 bpm.
Ethics approval and consent to participate
The research has been performed in accordance with the Declaration of Helsinki and was approved by the ethics committee of Kanazawa Medical University (the approval number: NO.R213), and written informed consent for participation was obtained from all subjects or from their parents.
Consent for publication
There are no details on individuals reported within the manuscript; therefore, consent for publication is not required.
Availability of data and materials
The primary data are open access on figshare and the DOI is as follows:
Author contributions
All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.
Disclosure
The authors declare that they have no competing interests in this work.