Analysis of Exercise Capacity of Children with Kawasaki Disease by a Coronary Artery z Score Model (ZSP Version 4) Derived by the Lambda-Mu-Sigma Method

Tuan, Sheng‐Hui; Su, Hung-Tzu; Chen, Chia-Hsin; Liou, I-Hsiu; Weng, Tzu‐Pin; Chen, Guanbo; Lin, Ko-Long

doi:10.1016/j.jpeds.2018.05.036

Cited by 11 publications

(12 citation statements)

References 24 publications

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“…Notably, despite the risk of developing CA abnormalities, previous studies had suggested that KD patients have comparable levels of cardiopulmonary fitness (CPF) to their normal peers due to compromised coronary perfusion when exercising after the acute stage of KD [ 5 , 6 ]. Similar results were discovered by a study using the Z-score of CA, which is a reliable scale for detecting CA aneurysms, besides the standard use of exercise tests [ 7 ]. However, little has been emphasized on whether gender differences would lead to contrary findings.…”

Section: Introductionsupporting

confidence: 85%

Differences between Sexes in Cardiopulmonary Fitness among Children and Adolescents with Kawasaki Disease

et al. 2022

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It is known that children and adolescents with Kawasaki disease (KD) can maintain normal cardiopulmonary fitness (CPF) after the disease’s acute stage has subsided. This study aimed to investigate whether gender differences affect CPF in children and adolescents with KD. We retrospectively reviewed a cohort of 204 participants (120 boys and 84 girls) with KD. All participants were instructed to complete a symptom-limited cardiopulmonary exercise test (CPET) adapted to assess their CPF. Based on body mass index (BMI), boys and girls were categorized into groups of underweight (19 boys and 12 girls), normal (62 boys and 59 girls), and overweight (39 boys and 13 girls). Although a similarity in body composition was found among both genders for KD subjects and normal Taiwanese peers, the percentage of overweight subjects was higher in KD boys than the normal Taiwanese boys. When comparing CPF for different BMI groups, the whole KD group showed no discrepancy, but a significantly lower peak VO2 for the overweight KD boys group was observed, representing poorer CPF. In conclusion, girls with KD had better CPF than boys, and gender stereotypes affect sports participation as well as self-efficacy, and may be contributing to poorer CPF in KD boys.

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Section: Introductionsupporting

confidence: 85%

Differences between Sexes in Cardiopulmonary Fitness among Children and Adolescents with Kawasaki Disease

et al. 2022

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“…Following IVIG treatment, most patients do not demonstrate significant mechanical dysfunction, although subclinical dysfunction can be detected which may persist for 1-3 months [43], and there is now growing evidence that ongoing myocardial abnormalities may occur [14]. Children with subclinical myocardial complications during acute KD display long-term cardiovascular complications, such as lower myocardial flow reserve and higher total coronary resistance [41,44,45], and potentially both longterm subclinical diastolic dysfunction [16] and a persistently increased end-diastolic volume many months after acute KD [37]. However, despite these descriptions of diastolic dysfunction, conclusive evidence of long-term changes in shortening or ejection fraction is lacking, and physicians are not directed to follow these indices in KD patients [46,47].…”

Section: Discussionmentioning

confidence: 99%

IL-1 receptor antagonist, anakinra, prevents myocardial dysfunction in a mouse model of Kawasaki disease vasculitis and myocarditis

Gorelik

Lee

Abe

et al. 2019

Clinical and Experimental Immunology

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Summary Kawasaki disease (KD) vasculitis is an acute febrile illness of childhood characterized by systemic vasculitis of unknown origin, and is the most common cause of acquired heart disease among children in the United States. While histological evidence of myocarditis can be found in all patients with acute KD, only a minority of patients are clinically symptomatic and a subset demonstrate echocardiographic evidence of impaired myocardial function, as well as increased left ventricular mass, presumed to be due to myocardial edema and inflammation. Up to a third of KD patients fail to respond to first‐line therapy with intravenous immunoglobulin (IVIG), and the use of interleukin (IL)‐1 receptor antagonist (IL‐1Ra, anakinra) is currently being investigated as an alternative therapeutic approach to treat IVIG‐resistant patients. In this study, we sought to investigate the effect of IL‐1Ra on myocardial dysfunction and its relation to myocarditis development during KD vasculitis. We used the Lactobacillus casei cell‐wall extract (LCWE)‐induced murine model of KD vasculitis and investigated the effect of IL‐1Ra pretreatment on myocardial dysfunction during KD vasculitis by performing histological, magnetic resonance imaging (MRI) and echocardiographic evaluations. IL‐1Ra pretreatment significantly reduced KD‐induced myocardial inflammation and N‐terminal pro B‐type natriuretic peptide (NT‐proBNP) release. Both MRI and echocardiographic studies on LCWE‐injected KD mice demonstrated that IL‐1Ra pretreatment results in an improved ejection fraction and a normalized left ventricular function. These findings further support the potential beneficial effects of IL‐1Ra therapy in preventing the cardiovascular complications in acute KD patients, including the myocarditis and myocardial dysfunction associated with acute KD.

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“…While most studies report improvement of myocardial function with treatment, there is now growing evidence that ongoing myocardial abnormalities occur in the long term (24). It has recently been shown that children suffering from subclinical myocardial complications during acute KD display long-term cardiovascular complications, such as lower myocardial flow reserve and higher total coronary resistance (33)(34)(35). However, few studies have considered a potential link between myocarditis in childhood KD and long-term persistent damage to the myocardium, including myocardial remodeling and fibrosis (30,36).…”

Section: Introductionmentioning

confidence: 99%

Myocardial fibrosis after adrenergic stimulation as a long-term sequela in a mouse model of Kawasaki disease vasculitis

et al. 2019

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Analysis of Exercise Capacity of Children with Kawasaki Disease by a Coronary Artery z Score Model (ZSP Version 4) Derived by the Lambda-Mu-Sigma Method

Cited by 11 publications

References 24 publications

Differences between Sexes in Cardiopulmonary Fitness among Children and Adolescents with Kawasaki Disease

Differences between Sexes in Cardiopulmonary Fitness among Children and Adolescents with Kawasaki Disease

IL-1 receptor antagonist, anakinra, prevents myocardial dysfunction in a mouse model of Kawasaki disease vasculitis and myocarditis

Myocardial fibrosis after adrenergic stimulation as a long-term sequela in a mouse model of Kawasaki disease vasculitis

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