Coronary Computed Tomographic Angiographic Findings in Patients With Kawasaki Disease

Han, Bo; Lesser, Andrew M.; Rosenthal, Kristi; Dummer, Kirsten; Grant, Katharine L.; Newell, Marc C.

doi:10.1016/j.amjcard.2014.09.004

Cited by 10 publications

(3 citation statements)

References 23 publications

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“…Although CTA with TAG assessment does involve radiation, because of advances in scanner technology this is feasible in patients with a history of KD with relatively low radiation doses. 15 …”

Section: Discussionmentioning

confidence: 99%

Assessment of Coronary Artery Aneurysms Caused by Kawasaki Disease Using Transluminal Attenuation Gradient Analysis of Computerized Tomography Angiograms

Gutiérrez

Shirinsky

Gagarina

et al. 2017

The American Journal of Cardiology

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Patients with coronary artery aneurysms (CAAs) resulting from Kawasaki disease (KD) are at risk for thrombosis and myocardial infarction. Current guidelines recommend CAA diameter ≥8 mm as the criterion for initiating systemic anticoagulation. Transluminal attenuation gradient (TAG) analysis has been proposed as a noninvasive method for evaluating functional significance of coronary stenoses using computerized tomography angiography (CTA), but has not previously been used in CAA. We hypothesized that abnormal hemodynamics in CAA caused by KD could be quantified using TAG analysis. We studied 23 patients with a history of KD who had undergone clinically indicated CTA. We quantified TAG in the major coronary arteries and aneurysm geometry was characterized using maximum diameter, aneurysm shape index, and sphericity index. A total of 55 coronary arteries were analyzed, 25 of which had at least 1 aneurysmal region. TAG in aneurysmal arteries was significantly lower than in normal arteries (− 23.5 ± 10.7 vs −10.5 ± 9.0, p = 0.00002). Aneurysm diameter, aneurysm shape index, and sphericity index were weakly correlated with TAG (r2 = 0.01, p = 0.6; r2 = 0.15, p = 0.06; r2 = 0.16, p = 0.04). This is the first application of TAG analysis to CAA caused by KD, and demonstrates significantly different TAG values in aneurysmal versus normal arteries. Lack of correlation between TAG and CAA geometry suggests that TAG may provide hemodynamic information not available from anatomy alone. TAG represents a possible extension to standard CTA for KD patients who may improve thrombotic risk stratification and aid in clinical decision making.

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Section: Discussionmentioning

confidence: 99%

Assessment of Coronary Artery Aneurysms Caused by Kawasaki Disease Using Transluminal Attenuation Gradient Analysis of Computerized Tomography Angiograms

Gutiérrez

Shirinsky

Gagarina

et al. 2017

The American Journal of Cardiology

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show abstract

“…Recent reports of both calcification and plaque identification by coronary CTA in high risk patients with a history of KD may identify a subset of patients at higher risk of future adverse event. 107 CMR is described for definition of coronary aneurysm, but is less sensitive than coronary CTA for identification of stenoses, calcifications, ectasia, and distal coronary artery disease. 105, …”

Section: Patientsmentioning

confidence: 99%

Computed Tomography Imaging in Patients with Congenital Heart Disease Part I: Rationale and Utility. An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT)

Han

Rigsby²,

Hlavacek

et al. 2015

Journal of Cardiovascular Computed Tomography

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166

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“…Physicians should be aware in MIS-C cases even if no aneurysmal involvement occurred and invasive imaging methods could be preferable with the symptoms of ischemia in the acute period. 2 As the clinical progress is on the good side with the improvement of the left ventricular ejection fraction after stent therapy, any further coronary imaging has not been performed yet. But as the guidelines suggest, 3 we are planning to take a computed tomography of the coronary arteries for exact evaluation in the follow-up.…”

mentioning

confidence: 99%

Reply to Letter to the Editor: “Multisystem Inflammatory Syndrome Versus Kawasaki Disease: Potential Differences in Pathogenetic and Clinical Implications”

Duman¹

2023

Anatol J Cardiol

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Coronary Computed Tomographic Angiographic Findings in Patients With Kawasaki Disease

Cited by 10 publications

References 23 publications

Assessment of Coronary Artery Aneurysms Caused by Kawasaki Disease Using Transluminal Attenuation Gradient Analysis of Computerized Tomography Angiograms

Assessment of Coronary Artery Aneurysms Caused by Kawasaki Disease Using Transluminal Attenuation Gradient Analysis of Computerized Tomography Angiograms

Computed Tomography Imaging in Patients with Congenital Heart Disease Part I: Rationale and Utility. An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT)

Reply to Letter to the Editor: “Multisystem Inflammatory Syndrome Versus Kawasaki Disease: Potential Differences in Pathogenetic and Clinical Implications”

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