Background: Measuring carotid strain is a noninvasive way to assess the mechanical properties of the arterial wall. Whether there is an association between carotid strain and coronary artery status after Kawasaki disease (KD) is unknown.
Methods: We enrolled 82 young adults, ages 15 to 30 yrs, with a history of KD (58% male), as well as 16 healthy controls (HC) of similar age (56% male). Carotid wall strain was measured from cine loops of common carotid artery B-mode ultrasound data using an offline optical flow analysis algorithm. Strain was normalized for age (Z-score) using a regression equation derived from a separate series of healthy young adults. Subjects were categorized based on their worst coronary artery status (normal, transiently dilated, aneurysm).
Results: The mean age of KD subjects and HC at the time of carotid measurements was 25 ± 8 and 28 ± 8 years, respectively (p=0.30). Mean time since onset of KD was 20 ± 8 yrs. KD subjects with transiently dilated coronary arteries had significantly higher carotid strain compared to those with normal coronaries (p=0.002) and to HC (p=0.01) (Figure); those with CAA had a nonsignificant trend toward lower carotid strain compared to other groups. KD subjects with normal coronaries had carotid strain similar to HC.
Conclusion: Young adults with a history of KD with normal coronary arteries also have normal carotid artery strain. Individuals with a history of transiently dilated coronary arteries had a paradoxical trend toward higher carotid strain. Thus, KD patients whose dilated coronary arteries return to normal may have healthier vasculature compared to other KD patients. The significance of this finding merits further study.