Follow-Up Duration of Echocardiography in Patients with Kawasaki Disease with No Initial Coronary Aneurysms
Copyright © 2021 Elsevier Inc. All rights reserved..
OBJECTIVE: To evaluate the optimal duration of echocardiographic follow-up in patients with Kawasaki disease without an initial coronary aneurysm.
STUDY DESIGN: In this single-center, retrospective, observational study, we reviewed the results of follow-up echocardiography in children with Kawasaki disease enrolled in the Prospective Observational Study on Stratified Treatment with Immunoglobulin Plus Steroid Efficacy for Kawasaki Disease from a children's hospital. The main enrollment criterion was the absence of coronary aneurysms, defined as a maximum z-score (Zmax) ≥2.5, in the proximal right coronary artery and the proximal left anterior descending artery within 9 days from treatment initiation. The primary outcome was Zmax on follow-up echocardiography at up to 5 years.
RESULTS: Among 386 patients, 106 (27.5%) received prednisolone with intravenous immunoglobulin for first-line therapy, and 57 (14.8%) showed a poor response. Echocardiography at 1 month detected 9 patients with a Zmax ≥2, including 3 (0.8%) with coronary aneurysms requiring additional antithrombotic treatment and observation. Of 7 patients (1.8%) with normal echocardiographic findings at 1 month but a Zmax ≥2 later, 2 were lost to follow-up and 5 experienced spontaneous resolution, but none of the 7 patients required any change in management.
CONCLUSIONS: The optimal duration of echocardiographic follow-up may be 1 month in patients with no initial coronary aneurysms and a Zmax <2 at 1 month. Coronary artery abnormalities observed after 1 month are rare and mostly benign in this category of patients.
| Errataetall: | |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:244 |
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| Enthalten in: |
The Journal of pediatrics - 244(2022) vom: 24. Mai, Seite 133-138.e1 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wang, Qianzhi [VerfasserIn] |
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| Links: |
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| Themen: |
American Heart Association |
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| Anmerkungen: |
Date Completed 11.05.2022 Date Revised 23.05.2022 published: Print-Electronic CommentIn: J Pediatr. 2022 May;244:10-12. - PMID 34958829 Citation Status MEDLINE |
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| doi: |
10.1016/j.jpeds.2021.11.022 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM333354427 |
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| 100 | 1 | |a Wang, Qianzhi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Follow-Up Duration of Echocardiography in Patients with Kawasaki Disease with No Initial Coronary Aneurysms |
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| 500 | |a Date Revised 23.05.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Pediatr. 2022 May;244:10-12. - PMID 34958829 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: To evaluate the optimal duration of echocardiographic follow-up in patients with Kawasaki disease without an initial coronary aneurysm | ||
| 520 | |a STUDY DESIGN: In this single-center, retrospective, observational study, we reviewed the results of follow-up echocardiography in children with Kawasaki disease enrolled in the Prospective Observational Study on Stratified Treatment with Immunoglobulin Plus Steroid Efficacy for Kawasaki Disease from a children's hospital. The main enrollment criterion was the absence of coronary aneurysms, defined as a maximum z-score (Zmax) ≥2.5, in the proximal right coronary artery and the proximal left anterior descending artery within 9 days from treatment initiation. The primary outcome was Zmax on follow-up echocardiography at up to 5 years | ||
| 520 | |a RESULTS: Among 386 patients, 106 (27.5%) received prednisolone with intravenous immunoglobulin for first-line therapy, and 57 (14.8%) showed a poor response. Echocardiography at 1 month detected 9 patients with a Zmax ≥2, including 3 (0.8%) with coronary aneurysms requiring additional antithrombotic treatment and observation. Of 7 patients (1.8%) with normal echocardiographic findings at 1 month but a Zmax ≥2 later, 2 were lost to follow-up and 5 experienced spontaneous resolution, but none of the 7 patients required any change in management | ||
| 520 | |a CONCLUSIONS: The optimal duration of echocardiographic follow-up may be 1 month in patients with no initial coronary aneurysms and a Zmax <2 at 1 month. Coronary artery abnormalities observed after 1 month are rare and mostly benign in this category of patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
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| 700 | 1 | |a Morikawa, Yoshihiko |e verfasserin |4 aut | |
| 700 | 1 | |a Akahoshi, Shogo |e verfasserin |4 aut | |
| 700 | 1 | |a Miyata, Koichi |e verfasserin |4 aut | |
| 700 | 1 | |a Sakakibara, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Matsushima, Takahiro |e verfasserin |4 aut | |
| 700 | 1 | |a Koyama, Yutaro |e verfasserin |4 aut | |
| 700 | 1 | |a Obonai, Toshimasa |e verfasserin |4 aut | |
| 700 | 1 | |a Kaneko, Tetsuji |e verfasserin |4 aut | |
| 700 | 1 | |a Miura, Masaru |e verfasserin |4 aut | |
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