Key result
Giant coronary aneurysms in Kawasaki disease were associated with a lower fractional flow reserve compared to non-giant aneurysms (0.90 vs 0.95; p=0.0004), though none were <0.75.
Why the study?
Does a giant coronary aneurysm cause a greater decline in fractional flow reserve compared to a non-giant aneurysm in patients with Kawasaki disease?
Observational (n=47)
Does a giant coronary aneurysm cause a greater decline in fractional flow reserve compared to a non-giant aneurysm in patients with Kawasaki disease?
Giant coronary aneurysms in Kawasaki disease cause a small but significant pressure drop, though not enough to cause ischemia by themselves (FFR > 0.75).
Modest FFR drop with giant aneurysms stays above ischemic threshold; hypothesis-generating for physiologic assessment in Kawasaki disease surveillance.
AIMS: A coronary aneurysm is one of the most frequent complications of Kawasaki disease, and yet there is little information concerning the haemodynamic abnormality influenced by the existence of a coronary aneurysm. When blood flow passes through an aneurysm, the turbulence that then occurs means that part of the initial energy is lost, and that energy loss could cause a drop in pressure, such as when passing through a stenotic lesion. The aim of this study is to prove the hypothesis that a giant aneurysm haemodynamically acts in a manner similar to that of stenosis. METHODS AND RESULTS: The study population consisted of 47 patients with a simple coronary aneurysm after Kawasaki disease. Fractional flow reserve was measured in 32 coronary aneurysms. The fractional flow reserve in non-giant aneurysms was 0.95±0.03 and 0.90±0.03 in giant aneurysms (p=0.0004). CONCLUSIONS: The present data demonstrated that the coronary aneurysm could give rise to a small decline of pressure along the artery. Since no aneurysm demonstrated a fractional flow reserve under 0.75, a simple aneurysm would not cause coronary ischaemia by itself. However, it could trigger a coronary ischaemia in case of multiple coronary aneurysms and a coronary aneurysm with mild stenosis.
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Murakami et al. (2011) conducted an observational in Kawasaki disease with coronary aneurysm (n=47). Giant coronary aneurysm vs. Non-giant coronary aneurysm was evaluated on Fractional flow reserve (p=0.0004). Giant coronary aneurysms in Kawasaki disease were associated with a lower fractional flow reserve compared to non-giant aneurysms (0.90 vs 0.95; p=0.0004), though none were <0.75.
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