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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 K...

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Autores principales: Dionne, Audrey, Ibrahim, Ragui, Gebhard, Catherine, Bakloul, Mohamed, Selly, Jean-Bernard, Leye, Mohamed, Déry, Julie, Lapierre, Chantale, Girard, Patrice, Fournier, Anne, Dahdah, Nagib
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599424/
https://www.ncbi.nlm.nih.gov/pubmed/25991013
http://dx.doi.org/10.1161/JAHA.115.001939
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author Dionne, Audrey
Ibrahim, Ragui
Gebhard, Catherine
Bakloul, Mohamed
Selly, Jean-Bernard
Leye, Mohamed
Déry, Julie
Lapierre, Chantale
Girard, Patrice
Fournier, Anne
Dahdah, Nagib
author_facet Dionne, Audrey
Ibrahim, Ragui
Gebhard, Catherine
Bakloul, Mohamed
Selly, Jean-Bernard
Leye, Mohamed
Déry, Julie
Lapierre, Chantale
Girard, Patrice
Fournier, Anne
Dahdah, Nagib
author_sort Dionne, Audrey
collection PubMed
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/m(2)). 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<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.
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spelling pubmed-45994242015-10-16 Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT) Dionne, Audrey Ibrahim, Ragui Gebhard, Catherine Bakloul, Mohamed Selly, Jean-Bernard Leye, Mohamed Déry, Julie Lapierre, Chantale Girard, Patrice Fournier, Anne Dahdah, Nagib J Am Heart Assoc Original Research 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/m(2)). 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<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. John Wiley & Sons, Ltd 2015-05-19 /pmc/articles/PMC4599424/ /pubmed/25991013 http://dx.doi.org/10.1161/JAHA.115.001939 Text en © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Dionne, Audrey
Ibrahim, Ragui
Gebhard, Catherine
Bakloul, Mohamed
Selly, Jean-Bernard
Leye, Mohamed
Déry, Julie
Lapierre, Chantale
Girard, Patrice
Fournier, Anne
Dahdah, Nagib
Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT)
title Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT)
title_full Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT)
title_fullStr Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT)
title_full_unstemmed Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT)
title_short Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT)
title_sort coronary wall structural changes in patients with kawasaki disease: new insights from optical coherence tomography (oct)
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599424/
https://www.ncbi.nlm.nih.gov/pubmed/25991013
http://dx.doi.org/10.1161/JAHA.115.001939
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