Cardiac MRI identified coronary artery aneurysms in patients with Kawasaki disease

Tacke CE. Circ Cardiovasc Imaging. 2011;4:712-720.

Issue: January 2012

In patients with Kawasaki disease, a comprehensive cardiac MRI protocol identified coronary artery pathology, ischemia and MI and compared favorably with echocardiography, new data suggested.

From September 2007 to October 2010, 63 patients (mean age, 14.6 years; 74.6% male) aged at least 8 years with Kawasaki disease underwent a comprehensive cardiac MRI protocol for routine coronary artery surveillance. The protocol included adenosine stress testing to evaluate complications. Before cardiac MRI performance, patients were assigned to three groups based on echocardiography data: patients without coronary artery aneurysms (n=41), patients with transient coronary artery aneurysms (n=12) and patients with persistent coronary artery aneurysms (n=10).

Researchers found normal coronary arteries in 46 patients using cardiac MRI and 23 coronary artery aneurysms in 15 patients. Thrombus formation was detected in six coronary artery aneurysms in four patients, wall motion disturbances and ischemia in four patients and delayed hyperenhancement indicating MI in five patients. Researchers also observed wall motion and perfusion abnormalities in territories supplied by affected coronary arteries.

Cardiac MRI results and recent echocardiography findings were also compared in all patients. On cardiac MRIs that showed no coronary artery aneurysms, recent echocardiography showed normal coronary arteries. However, “in six of the 15 patients with coronary artery aneurysms on cardiac MRI, coronary artery aneurysms were not detected by echocardiography,” according to the researchers.

“We recommend future studies to incorporate cardiac MRI in the guidelines for follow-up of patients with Kawasaki disease,” the researchers concluded.

Disclosure: The researchers report no relevant financial disclosures.

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