Transthoracic Doppler assessment of coronary flow velocity reserve in children with Kawasaki disease: Comparison with coronary angiography and thallium-201 imaging

• Published in: Journal of the American College of Cardiology 2002-11, Vol.40 (10), p.1816-1824
• Main Authors: HIRAISHI, Satoshi, HIROTA, Hamao, HORIGUCHI, Yasunori, TAKEDA, Nobuhiro, FUJINO, Nobuyuki, OGAWA, Natsuko, NAKAHATA, Yayoi
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Arteries - diagnostic imaging; Arteries - physiopathology; Biological and medical sciences; Blood Flow Velocity - physiology; Cardiology; Child; Child Welfare; Child, Preschool; Coronary Angiography; Coronary Artery Bypass; Coronary Stenosis - diagnosis; Coronary Stenosis - epidemiology; Coronary Stenosis - physiopathology; Coronary vessels; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; Echocardiography, Doppler - methods; Female; Heart attacks; Hemodynamics - physiology; Humans; Male; Medical imaging; Medical sciences; Mucocutaneous Lymph Node Syndrome - diagnosis; Mucocutaneous Lymph Node Syndrome - epidemiology; Mucocutaneous Lymph Node Syndrome - physiopathology; Observer Variation; Predictive Value of Tests; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Sensitivity and Specificity; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(02)02479-8

The purpose of this study was to determine the feasibility of coronary flow velocity reserve (CFVR) measurement by transthoracic Doppler echocardiography (TTDE) in children with Kawasaki disease (KD). Doppler-derived CFVR is a reliable marker predicting the presence of myocardial ischemia. We studied 49 patients (median age 11 years) with KD. The CFVR was calculated as the ratio of hyperemic to basal peak (peak CFVR) and mean (mean CFVR) diastolic flow velocities in the posterior descending coronary artery (PD) and left anterior descending coronary artery (LAD). The CFVR measurements by TTDE were compared with the results of coronary angiography, thallium-201 (Tl-201) single-photon emission computed tomography (SPECT), and intracoronary Doppler study. The CFVR measurements by TTDE were obtained in 92 (94%) of 98 vessels of the PD and LAD in 49 study patients. Both peak and mean CFVRs for 21 stenotic vessels were significantly smaller than those for 35 normal vessels and for 20 vessels with aneurysmal lesions (p < 0.0001). Peak and mean CFVR