Evaluation of Coronary Lesions in Patients With a History of Kawasaki Disease by Quantifying “Run Off” on Coronary Angiography

To evaluate coronary artery involvement and hemodynamics in patients with a history of Kawasaki disease, the disappearance time of contrast medium (run-off time) was quantified using X-ray densitometry. The run-off time of the morphologically normal coronary artery was thought to serve as an indicator of coronary flow velocity, and it correlated with the dilatation ratio of coronary artery diameter in response to dipyridamole loading. These results suggest that impairment of the coronary artery intima resulting from Kawasaki disease influences coronary flow, even in cases with morphologically normal coronary areries. The run-off time of coronary arteries with maximal diameters of more than 4.0 mm was significantly (p<0.01) greater than that of non-dilated coronary arteries, and that of giant coronary aneurysm that progressed to obstruction was more than 500%. The run-off time of coronary lesions of each grade improved significantly after dipyridamole loading (p<0.01).