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Background: Recently we reported that the carotid arteries of Kawasaki disease (KD) appear to develop mild sclerotic changes shortly after onset using the speckle tracking echocardiography. However, it remains to be elucidated what factors hemodynamically may induce these sclerotic changes. Objectives: The aim of this study was to investigate the relationship between KD related-angiopathy and arterial pressure wave reflection using the two-dimensional speckle tracking echocardiography and radial augmentation index (AIx). Subjects & Methods: We studied a cohort of children with history of KD. The subjects were 87 KD patients (age, 9.7±2.9 years) and 93 healthy controls (11.3±3.2 years). As for our methodology, the two regions of interest (ROI) for speckle tracking were manually positioned at near and far carotid arterial walls using a Philips iE33. Continuously, we examined the following strain values: (A) peak strain in expansion phase, (B) peak strain before aortic valve closure, and (C) strain value at aortic valve closure (Figure 1). Also, we examined two ratios, B/A and C/A, for emphasizing recoil function. Concurrently, the radial AIx were obtained. Results: KD patients had significantly the lower A values, the higher B/A, and the higher radial AIx, compared with controls. Furthermore, there was good correlation between B/A and radial AIx in KD. Conclusions: It is well known that a higher AIx results from earlier arrival of reflected pressure waves and an early return of reflected waves is closely correlated with peripheral stiffness. Therefore, these results indicate that peripheral angiopathy may induce sclerotic changes of carotid arteries in KD patients.

Background: Recent epidemiological studies have suggested that some patients with Kawasaki disease (KD) have an atopic tendency. However, it is not clear what the long-term prognosis will be for KD-patient with allergic disease. We aim to investigate the long-term prognosis of KD-patient with allergic disease. Subjects & Methods: We studied a cohort of KD-patient (n=58, follow-up age; 9.95±1.84 years), in whom we examined total serum IgE and specific IgE at KD-onset (onset age; 2.13±1.84 years). Using retrospective patient medical record analysis, we evaluated the prevalence of bronchial asthma at onset and follow-up of KD. In addition, we examined the hospitalization rate, medical history and family history in pediatric bronchial asthma after KD-onset. Results: In our study, KD-patient had markedly higher total serum IgE and prevalence of bronchial asthma at onset of KD than the general children’s population, as reported by Japanese national government (Table 1). The prevalence of bronchial asthma at follow-up was similar to the general children’s population. 9 children had already had a diagnosis of a bronchial asthma at KD-onset. 8 children had subsequently developed bronchial asthma after KD-onset. In these 2 groups, however, 6 and 8 children, respectively, had remitted during follow-up. Nobody was hospitalized for asthmatic exacerbation after KD-onset. Conclusions: These findings demonstrate that KD-patient with atopic bronchial asthma at onset have not developed severe allergic reaction. There results provide that the pathogenic mechanism of KD might weakly or transiently provoke an elevation of total IgE and the developing of allergies.