Background: The endothelium is a single layer of epithelial cells that lines the blood vessels and is a major component in maintaining vascular homeostasis. Impaired endothelial cell (EC) function can contribute to cardiovascular disease states, but whether there is an association between endothelial dysfunction and the presence of coronary artery aneurysms after Kawasaki disease (KD) is unknown.
Methods: We enrolled 110 teens and young adults, ages 16 to 30 years, with a history of KD (61% male), as well as 30 healthy controls (HC, 53% male). EC function (reactive hyperemic response after a 5 minutes brachial artery occlusion) was measured using the EndoPAT 2000. Reactive hyperemia index (RHI) and PAT ratios were determined. KD subjects were categorized based on their worst coronary artery status (normal, transiently dilated/resolved aneurysm, aneurysm).
Results: The mean age of KD subjects and HC at the time of EndoPAT was 25 ± 9 and 26 ± 7 years, respectively (p=0.42). Mean time since onset of KD was 23 ± 19 years. Subjects with a history of transiently dilated/resolved aneurysms had a higher mean lnRHI compared to other KD subjects (0.91 vs 0.74, p=0.01) and HC (0.72, p=0.02). When PAT ratio was evaluated as a function of time after occlusion release, those with transiently dilated/resolved aneurysms had a trend toward a more favorable profile while other groups appeared similar (Figure).
Conclusion: Most young adults with a history of KD have normal EC function. Individuals with a history of transiently dilated coronary arteries had a paradoxical trend toward better EC function, which may indicate healthier vasculature. The significance of this finding merits further study.