Evaluation of endothelial and myocardial functions in patients with Kawasaki disease in the long term

In this study, 26 patients who had Kawasaki disease at least 6 months ago, who were currently 7 years of age or older, and 24 children who presented with various symptoms but no pathologic findings were included. Information on the age at diagnosis, positive diagnostic criteria at the time of diagnosis, the number of days of fever at the time of diagnosis, echocardiographic findings at the time of diagnosis, treatments used, and whether coronary involvement persisted during follow-up were collected. Conventional transthoracic echocardiography, speckle tracking echocardiography (STE) and pulse wave analysis (PWA) were performed in all patients. The patient group underwent exercise testing followed by repeat STE. Serum lipid profile was obtained from the patient group. Gender and age distribution, rate and location of coronary involvement, positive diagnostic criteria at the time of diagnosis and number of febrile days were found to be consistent with the literature. Pulse wave velocity on PWA was found to be higher in the patient group and was considered as an indicator of long-term arterial stiffness (p=0.043). When strain data of the patient and control groups were compared, anterior middle (p=0.007), anterior apical (p=0.042), anteroseptal middle (p=0.006), inferior middle (p=0.036), inferior apical (p=0.040), inferolateral apical (p=0.005) segments and global strain (p=0.001) values were lower in the patient group. This was evaluated as an indicator of the development of myocardial dysfunction in patients in the long term. In addition, when the pre- and post-exercise strain data of the patient group were evaluated, it was found that the values in the anteroseptal basal (p=0.021), anterolateral basal (p=0.024) and inferoseptal basal (p=0.001) segments increased in longitudinal measurements compared to pre-exercise. In conclusion, PWA and strain measurements have been shown to be very valuable in detecting endomyocardial dysfunction at a subclinical level and in predicting coronary artery disease in long-term follow-up of patients.