Open AccessCoronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography ( OCT )
Author(s) -
Dionne Audrey,
Ibrahim Ragui,
Gebhard Catherine,
Bakloul Mohamed,
Selly JeanBernard,
Leye Mohamed,
Déry Julie,
Lapierre Chantale,
Girard Patrice,
Fournier Anne,
Dahdah Nagib
Publication year - 2015
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.115.001939
Subject(s) - medicine , kawasaki disease , radiology , coronary artery disease , culprit , angiography , artery , cardiology , myocardial infarction
Background Coronary artery aneurysms ( CAA ) are serious complications of Kawasaki disease ( KD ). Optical coherence tomography ( OCT ) is a high‐resolution intracoronary imaging modality that characterizes coronary artery wall structure. The purpose of this work was to describe CAA wall sequelae after KD . Methods and Results KD patients scheduled for routine coronary angiography underwent OCT imaging between March 2013 and August 2014. Subjects’ clinical courses, echocardiography, and coronary angiography examinations were reviewed retrospectively. OCT was performed in 18 patients aged 12.4±5.5 years, 9.0±5.1 years following onset of KD . Of those, 14 patients (77.7%) had a history of CAA (7 with giant CAA and 7 with regressed CAA at time of OCT ). Intracoronary nitroglycerin was given to all patients (88.4±45.5 μg/m 2 ). Mean radiation dose was 10.9±5.2 mG y/kg. One patient suffered from a transitory uneventful vasospasm at the site of a regressed CAA ; otherwise no major procedural complications occurred. The most frequent abnormality observed on OCT was intimal hyperplasia (15 patients, 83.3%) seen at both aneurysmal sites and angiographically normal segments amounting to 390.8±166.0 μm for affected segments compared to 61.7±17 μm for unaffected segments ( P <0.001). Disappearance of the media, and presence of fibrosis, calcifications, macrophage accumulation, neovascularization, and white thrombi were seen in 72.2%, 77.8%, 27.8%, 44.4%, and 33.3% of patients. Conclusions In this study, OCT proved safe and insightful in the setting of KD , with the potential to add diagnostic value in the assessment of coronary abnormalities in KD . The depicted coronary structural changes correspond to histological findings previously described in KD .