Key result
Adolescents with a history of Kawasaki disease had lower exercise capacity compared to healthy matched controls at final follow-up.
Why the study?
Kawasaki disease is the most common pediatric vasculitis, but its influence on cardiopulmonary function and echocardiographic findings from childhood to adolescence required evaluation through serial follow-ups.
Does a history of Kawasaki disease reduce cardiopulmonary function in adolescence compared to healthy peers?
Cohort (n=60)
No
Does a history of Kawasaki disease reduce cardiopulmonary function in adolescence compared to healthy peers?
While children with a history of Kawasaki disease have comparable exercise capacity to healthy peers initially, their aerobic metabolism and peak exercise load capacities become significantly lower by adolescence.
Answers are grounded in this paper and cite their sources.
Serial CPET/echo in KD may show evolving function; hypothesis-generating and leaves open need for prospective confirmation.
Objective Kawasaki disease (KD) is the most common form of pediatric vasculitis. We evaluated the influence of KD on cardiopulmonary function and analyzed the echocardiographic findings of patients with KD through serial follow-ups from childhood to adolescence. Methods This was a retrospective study. We recruited patients with KD after the acute stage who underwent at least two (with >1-year interval between visits) cardiopulmonary exercise testing (CPET) and echocardiographic examinations in the last 10 years. Cardiopulmonary function was determined through CPET on a treadmill. The maximum Z score (Max-Z) of the proximal left anterior descending coronary artery or right coronary artery was determined using echocardiography. Healthy peers matched for age, sex, and body mass index with serial CPET and echocardiographic data were recruited as a control group. Results Each group consisted of 30 participants with comparable basic characteristics. No significant differences in the variables of the first CPET were observed between the two groups. In the final CPET, the control group had a higher percentage of measured oxygen consumption (Vo2) at the anaerobic threshold (AT) to the predicted peak Vo2 (p = 0.016), higher percentage of measured peak Vo2 to the predicted peak Vo2 (p = 0.0004), and higher Vo2 at AT (p < 0.0001) than those of the KD group. No significant difference in the percentage of distribution of Max-Z was observed between the first and final echocardiographic examinations. Conclusions Children with a history of KD had comparable exercise capacity to their healthy peers. However, in the follow-up, the aerobic metabolism and peak exercise load capacities of adolescents with KD were significantly lower than those of control adolescents.
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Lin et al. (2022) conducted a cohort in Kawasaki disease (n=60). History of Kawasaki disease vs. Healthy matched controls was evaluated on Percentage of measured peak oxygen consumption (Vo2) to the predicted peak Vo2 at final follow-up (p=0.0004). Adolescents with a history of Kawasaki disease had lower exercise capacity compared to healthy matched controls at final follow-up.
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