Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT)

Background Coronary artery aneurysms (CAA) are serious complications of Kawasaki disease (KD). Optical coherence tomography (OCT) is a high‐resolution intracoronary imaging modality that characterizes coronary artery wall structure. The purpose of this work was to describe CAA wall sequelae after KD...

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Published in:Journal of the American Heart Association 2015-05, Vol.4 (5), p.n/a
Main Authors: Dionne, Audrey, Ibrahim, Ragui, Gebhard, Catherine, Bakloul, Mohamed, Selly, Jean‐Bernard, Leye, Mohamed, Déry, Julie, Lapierre, Chantale, Girard, Patrice, Fournier, Anne, Dahdah, Nagib
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Language:English
Subjects:
Adolescent
Child
Child, Preschool
Coronary Aneurysm - diagnosis
Coronary Aneurysm - etiology
Coronary Angiography - methods
coronary disease
Coronary Vessels - pathology
Female
Follow-Up Studies
Humans
imaging
Male
Mucocutaneous Lymph Node Syndrome - complications
Nitroglycerin - administration & dosage
Original Research
pediatrics
Tomography, Optical Coherence - methods
Vasodilator Agents - administration & dosage
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creator Dionne, Audrey
Ibrahim, Ragui
Gebhard, Catherine
Bakloul, Mohamed
Selly, Jean‐Bernard
Leye, Mohamed
Déry, Julie
Lapierre, Chantale
Girard, Patrice
Fournier, Anne
Dahdah, Nagib
description Background Coronary artery aneurysms (CAA) are serious complications of Kawasaki disease (KD). Optical coherence tomography (OCT) is a high‐resolution intracoronary imaging modality that characterizes coronary artery wall structure. The purpose of this work was to describe CAA wall sequelae after KD. Methods and Results KD patients scheduled for routine coronary angiography underwent OCT imaging between March 2013 and August 2014. Subjects’ clinical courses, echocardiography, and coronary angiography examinations were reviewed retrospectively. OCT was performed in 18 patients aged 12.4±5.5 years, 9.0±5.1 years following onset of KD. Of those, 14 patients (77.7%) had a history of CAA (7 with giant CAA and 7 with regressed CAA at time of OCT). Intracoronary nitroglycerin was given to all patients (88.4±45.5 μg/m2). Mean radiation dose was 10.9±5.2 mGy/kg. One patient suffered from a transitory uneventful vasospasm at the site of a regressed CAA; otherwise no major procedural complications occurred. The most frequent abnormality observed on OCT was intimal hyperplasia (15 patients, 83.3%) seen at both aneurysmal sites and angiographically normal segments amounting to 390.8±166.0 μm for affected segments compared to 61.7±17 μm for unaffected segments (P
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Optical coherence tomography (OCT) is a high‐resolution intracoronary imaging modality that characterizes coronary artery wall structure. The purpose of this work was to describe CAA wall sequelae after KD. Methods and Results KD patients scheduled for routine coronary angiography underwent OCT imaging between March 2013 and August 2014. Subjects’ clinical courses, echocardiography, and coronary angiography examinations were reviewed retrospectively. OCT was performed in 18 patients aged 12.4±5.5 years, 9.0±5.1 years following onset of KD. Of those, 14 patients (77.7%) had a history of CAA (7 with giant CAA and 7 with regressed CAA at time of OCT). Intracoronary nitroglycerin was given to all patients (88.4±45.5 μg/m2). Mean radiation dose was 10.9±5.2 mGy/kg. One patient suffered from a transitory uneventful vasospasm at the site of a regressed CAA; otherwise no major procedural complications occurred. The most frequent abnormality observed on OCT was intimal hyperplasia (15 patients, 83.3%) seen at both aneurysmal sites and angiographically normal segments amounting to 390.8±166.0 μm for affected segments compared to 61.7±17 μm for unaffected segments (P&lt;0.001). Disappearance of the media, and presence of fibrosis, calcifications, macrophage accumulation, neovascularization, and white thrombi were seen in 72.2%, 77.8%, 27.8%, 44.4%, and 33.3% of patients. Conclusions In this study, OCT proved safe and insightful in the setting of KD, with the potential to add diagnostic value in the assessment of coronary abnormalities in KD. The depicted coronary structural changes correspond to histological findings previously described in KD.</description><identifier>ISSN: 2047-9980</identifier><identifier>EISSN: 2047-9980</identifier><identifier>DOI: 10.1161/JAHA.115.001939</identifier><identifier>PMID: 25991013</identifier><language>eng</language><publisher>England: John Wiley &amp; Sons, Ltd</publisher><subject>Adolescent ; Child ; Child, Preschool ; Coronary Aneurysm - diagnosis ; Coronary Aneurysm - etiology ; Coronary Angiography - methods ; coronary disease ; Coronary Vessels - pathology ; Female ; Follow-Up Studies ; Humans ; imaging ; Male ; Mucocutaneous Lymph Node Syndrome - complications ; Nitroglycerin - administration &amp; dosage ; Original Research ; pediatrics ; Tomography, Optical Coherence - methods ; Vasodilator Agents - administration &amp; dosage</subject><ispartof>Journal of the American Heart Association, 2015-05, Vol.4 (5), p.n/a</ispartof><rights>2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.</rights><rights>2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5041-c28b930bd42801e419e3730bbaf136d9332d8485ff108477476191e1859fca7d3</citedby><cites>FETCH-LOGICAL-c5041-c28b930bd42801e419e3730bbaf136d9332d8485ff108477476191e1859fca7d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599424/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599424/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11562,27924,27925,46052,46476,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25991013$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dionne, Audrey</creatorcontrib><creatorcontrib>Ibrahim, Ragui</creatorcontrib><creatorcontrib>Gebhard, Catherine</creatorcontrib><creatorcontrib>Bakloul, Mohamed</creatorcontrib><creatorcontrib>Selly, Jean‐Bernard</creatorcontrib><creatorcontrib>Leye, Mohamed</creatorcontrib><creatorcontrib>Déry, Julie</creatorcontrib><creatorcontrib>Lapierre, Chantale</creatorcontrib><creatorcontrib>Girard, Patrice</creatorcontrib><creatorcontrib>Fournier, Anne</creatorcontrib><creatorcontrib>Dahdah, Nagib</creatorcontrib><title>Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT)</title><title>Journal of the American Heart Association</title><addtitle>J Am Heart Assoc</addtitle><description>Background Coronary artery aneurysms (CAA) are serious complications of Kawasaki disease (KD). Optical coherence tomography (OCT) is a high‐resolution intracoronary imaging modality that characterizes coronary artery wall structure. The purpose of this work was to describe CAA wall sequelae after KD. Methods and Results KD patients scheduled for routine coronary angiography underwent OCT imaging between March 2013 and August 2014. Subjects’ clinical courses, echocardiography, and coronary angiography examinations were reviewed retrospectively. OCT was performed in 18 patients aged 12.4±5.5 years, 9.0±5.1 years following onset of KD. Of those, 14 patients (77.7%) had a history of CAA (7 with giant CAA and 7 with regressed CAA at time of OCT). Intracoronary nitroglycerin was given to all patients (88.4±45.5 μg/m2). Mean radiation dose was 10.9±5.2 mGy/kg. One patient suffered from a transitory uneventful vasospasm at the site of a regressed CAA; otherwise no major procedural complications occurred. The most frequent abnormality observed on OCT was intimal hyperplasia (15 patients, 83.3%) seen at both aneurysmal sites and angiographically normal segments amounting to 390.8±166.0 μm for affected segments compared to 61.7±17 μm for unaffected segments (P&lt;0.001). Disappearance of the media, and presence of fibrosis, calcifications, macrophage accumulation, neovascularization, and white thrombi were seen in 72.2%, 77.8%, 27.8%, 44.4%, and 33.3% of patients. Conclusions In this study, OCT proved safe and insightful in the setting of KD, with the potential to add diagnostic value in the assessment of coronary abnormalities in KD. The depicted coronary structural changes correspond to histological findings previously described in KD.</description><subject>Adolescent</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Coronary Aneurysm - diagnosis</subject><subject>Coronary Aneurysm - etiology</subject><subject>Coronary Angiography - methods</subject><subject>coronary disease</subject><subject>Coronary Vessels - pathology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>imaging</subject><subject>Male</subject><subject>Mucocutaneous Lymph Node Syndrome - complications</subject><subject>Nitroglycerin - administration &amp; dosage</subject><subject>Original Research</subject><subject>pediatrics</subject><subject>Tomography, Optical Coherence - methods</subject><subject>Vasodilator Agents - administration &amp; dosage</subject><issn>2047-9980</issn><issn>2047-9980</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>DOA</sourceid><recordid>eNqFkcFv2yAUxtG0aa3SnnebOG6HtGDAhh0qRd7SpquWScvUI8IYbFrHROAsy39fUndVexoX3oPv_R68D4APGJ1hnOPz69nVLEXsDCEsiHgDjjNEi6kQHL19ER-B0xjvUFp5VhAm3oOjjAmBESbH4G_pg-9V2MNb1XXw1xC2etgG1cGyVX1jInQ9_KkGZ_ohwls3tPC72qmo7h386qJR0XyBP8wOLvromjZp5sGv4XIzOH2A-NYE02sDV37tm6A27R5-WparzyfgnVVdNKdP-wT8nn9blVfTm-XlopzdTDVDFE91xitBUFXTjCNsKBaGFCmvlMUkrwUhWc0pZ9ZixGlR0CLHAhvMmbBaFTWZgMXIrb26k5vg1umz0isnHw98aKQK6bGdkbbKmSYK6YpTWousYjVJfSttLRcs9ZqAi5G12VZrU-s0kzSpV9DXN71rZeP_SJrmTTOaAOcjQAcfYzD2uRYjefBUHjxNEZOjp6ni48uWz_p_DiYBHQU715n9_3iHnAiOyQNKC6y2</recordid><startdate>201505</startdate><enddate>201505</enddate><creator>Dionne, Audrey</creator><creator>Ibrahim, Ragui</creator><creator>Gebhard, Catherine</creator><creator>Bakloul, Mohamed</creator><creator>Selly, Jean‐Bernard</creator><creator>Leye, Mohamed</creator><creator>Déry, Julie</creator><creator>Lapierre, Chantale</creator><creator>Girard, Patrice</creator><creator>Fournier, Anne</creator><creator>Dahdah, Nagib</creator><general>John Wiley &amp; 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dosage</topic><topic>Original Research</topic><topic>pediatrics</topic><topic>Tomography, Optical Coherence - methods</topic><topic>Vasodilator Agents - administration &amp; dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dionne, Audrey</creatorcontrib><creatorcontrib>Ibrahim, Ragui</creatorcontrib><creatorcontrib>Gebhard, Catherine</creatorcontrib><creatorcontrib>Bakloul, Mohamed</creatorcontrib><creatorcontrib>Selly, Jean‐Bernard</creatorcontrib><creatorcontrib>Leye, Mohamed</creatorcontrib><creatorcontrib>Déry, Julie</creatorcontrib><creatorcontrib>Lapierre, Chantale</creatorcontrib><creatorcontrib>Girard, Patrice</creatorcontrib><creatorcontrib>Fournier, Anne</creatorcontrib><creatorcontrib>Dahdah, Nagib</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Free Archive</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of the American Heart Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dionne, Audrey</au><au>Ibrahim, Ragui</au><au>Gebhard, Catherine</au><au>Bakloul, Mohamed</au><au>Selly, Jean‐Bernard</au><au>Leye, Mohamed</au><au>Déry, Julie</au><au>Lapierre, Chantale</au><au>Girard, Patrice</au><au>Fournier, Anne</au><au>Dahdah, Nagib</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT)</atitle><jtitle>Journal of the American Heart Association</jtitle><addtitle>J Am Heart Assoc</addtitle><date>2015-05</date><risdate>2015</risdate><volume>4</volume><issue>5</issue><epage>n/a</epage><issn>2047-9980</issn><eissn>2047-9980</eissn><abstract>Background Coronary artery aneurysms (CAA) are serious complications of Kawasaki disease (KD). Optical coherence tomography (OCT) is a high‐resolution intracoronary imaging modality that characterizes coronary artery wall structure. The purpose of this work was to describe CAA wall sequelae after KD. Methods and Results KD patients scheduled for routine coronary angiography underwent OCT imaging between March 2013 and August 2014. Subjects’ clinical courses, echocardiography, and coronary angiography examinations were reviewed retrospectively. OCT was performed in 18 patients aged 12.4±5.5 years, 9.0±5.1 years following onset of KD. Of those, 14 patients (77.7%) had a history of CAA (7 with giant CAA and 7 with regressed CAA at time of OCT). Intracoronary nitroglycerin was given to all patients (88.4±45.5 μg/m2). Mean radiation dose was 10.9±5.2 mGy/kg. One patient suffered from a transitory uneventful vasospasm at the site of a regressed CAA; otherwise no major procedural complications occurred. The most frequent abnormality observed on OCT was intimal hyperplasia (15 patients, 83.3%) seen at both aneurysmal sites and angiographically normal segments amounting to 390.8±166.0 μm for affected segments compared to 61.7±17 μm for unaffected segments (P&lt;0.001). Disappearance of the media, and presence of fibrosis, calcifications, macrophage accumulation, neovascularization, and white thrombi were seen in 72.2%, 77.8%, 27.8%, 44.4%, and 33.3% of patients. Conclusions In this study, OCT proved safe and insightful in the setting of KD, with the potential to add diagnostic value in the assessment of coronary abnormalities in KD. The depicted coronary structural changes correspond to histological findings previously described in KD.</abstract><cop>England</cop><pub>John Wiley &amp; Sons, Ltd</pub><pmid>25991013</pmid><doi>10.1161/JAHA.115.001939</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Child
Child, Preschool
Coronary Aneurysm - diagnosis
Coronary Aneurysm - etiology
Coronary Angiography - methods
coronary disease
Coronary Vessels - pathology
Female
Follow-Up Studies
Humans
imaging
Male
Mucocutaneous Lymph Node Syndrome - complications
Nitroglycerin - administration & dosage
Original Research
pediatrics
Tomography, Optical Coherence - methods
Vasodilator Agents - administration & dosage
title Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT)
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