Peripheral Vascular Dysfunction in Patients with Coronary Artery Aneurysms Caused by Kawasaki Disease Using Laser Doppler Monitoring

  • Motofumi Iemura, Cardiovascular Research Institute, Kurume University, Japan
  • Tetsu Sugimura, Sugimura Child Clinic, Japan
  • Shintaro Kishimoto, Department of Pediatrics, Kurume University, Japan
  • Hiroshi Nishino, Department of Pediatrics, Kurume University, Japan
  • yusuke Koteda, Department of Pediatrics, Kurume University, Japan
  • yoshiyuki Kudo, Department of Pediatrics, Kurume University, Japan
  • Kenji Suda, Department of Pediatrics, Kurume University, Japan
  • Toyojiro Matsuisi, Department of Pediatrics, Kurume University, Japan

    • BACKGROUND: Endothelial dysfunction of coronary aneurysms (CAL) and regressed coronary arteries after Kawasaki disease (KD) is widely recognized. However, peripheral vascular function, especially small and micro sized vessels, is still uncertain. PURPOSE: To clarify the peripheral vascular function by using laser Doppler monitoring system (PeriFlux system 5000). METHODS: Subjects were 23 patients (CA) with KD (18.7±6.4 years old) who were still existed CAL and 17 healthy controls (CONT)(20.4±6.2 years old). All the measurements were performed in the supine position resting on a bed in a temperature-controlled room. After attachment of a sphygmomanometric cuff above the forearm, the laser Doppler probe was fixed to the skin of the thenar. The resting perfusion unit (rest PU) was monitored from 3 minutes and then forearm cuff was inflated up to 200mmHg. After 3 minutes occlusion was suddenly released, the maximum perfusion unit (max PU) and time to max PU were recorded till hyperemia subsided. RESULTS: There were no significant differences in rest PU (mean±SD= 188.5±108.9 in CA vs. 179.5±163.4 in CONT) and max PU (315.1±83.6 in CA vs. 329.9±128.7 in CONT). However, Time to max PU in CA was significantly longer than Time to max PU in CONT (37.4±30.5 seconds in CA vs. 17.0±10.8 seconds in CONT, p<0.05). CONCLUSION: These data suggested that peripheral vascular function, including endothelium, was impaired in patients with CAL. We considered that this laser Doppler monitoring system was non-invasive, practical, and useful system for measurement of vascular function.