Abstract 158: Central arterial elasticity in patients post Kawasaki Disease - a Cardiac Magnetic Resonance Imaging (CMR) study

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Background: Measures of central arterial elasticity such as aortic pulse wave velocity (APWV) have been shown to correlate with development of atherosclerosis. Endothelial dysfunction after Kawasaki disease has been shown to persist despite resolution of anatomically demonstrable coronary anomalies and this may be reflected in abnormal central arterial elasticity. Measurement of APWV by CMR is most robust but has seldom been reported in KD patients.

Aim: In a novel pilot study, we measured the APWV using CMR in patients with no coronary complications post KD. We compared this to age and gender matched published controls and APWV values measured on ultrasound.

Methods: 10 KD patients (with no coronary involvement) in our hospital database, at least 12 years post KD diagnosis, with no known personal cardiovascular risk factors or family history of premature cardiovascular disease, were recruited.

Each subject underwent both MRI and ultrasound investigations to determine the APWV. The results were compared using standard (z) scores calculated from published norms.

Results: 3 of the 10 KD subjects had significant z scores using CMR measurements of APWV ranging from +2.07 to +3.35. However, no significant difference was found on overall non parametric comparisons of measurements.

The US measurements of APWV all did not yield significant z scores. Z scores obtained from US and CMR measurements for the same subject showed no concordance.

Conclusion: Central arterial stiffness tends to be higher in KD patients many years following the acute illness when assessed by CMR methods. CMR may be a more sensitive method than ultrasound for assessing central arterial stiffness post KD. The clinical implication of these findings require longitudinal follow up.

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