Correlation Between The Changing Of Endothelial Microparticles And Imaging Of Endothelial Dysfunction In Kawasaki Disease

PART-1Imaging exploration of vascular endothelial dysfunction in Kawasaki diseaseObjective:To explore sonographic features of brachial arterial FMD in the patients with Kawasaki Disease and to evaluate vascular endothelial dysfunction in different phases of Kawasaki disease (KD).Methods:The sonographic examination of brachial arterial response to reactive hyperemia (flow mediated dilatation, FMD) were prospectively explored in the children with KD.And50children were selected in acute phase,47in subacute phase, and48in convalescence phase. Also19healthy children and28children with fever-of-unknown were separately chosen as control groups. Again the48patients in convalescence were divided into two groups based on whether their coronary artery lesion occured or not.Results:There were significantly differences in the values of FMD among the five groups.(χ2=54.242,P<0.001). Compared to control groups of normal and Fou, the values of FMD significantly increased in acute, subacute, convalescence phases.(χ2=54.242, P<0.001). There were no statistical significances in FMD values between the two groups with coronary arterial lesion or without in the convalescence phase.(P=0.421).Conclusions:The impairment of vascular endothelial function was observed in acute, subacute and convalescence phases of KD. The sonography of FMD via brachial arteries is a feasible examination of systemic vascular endothelial dysfunction, and is worthy of further clinical application. PART-2Correlation between the changing of endothelial microparticles and flow mediated dilatation in Kawasaki DiseaseObjective:To evaluate plasma levels of endothelial microparticles (EMPs) in patients with Kawasaki disease, and to investigate the relationship between the values of FMD of brachial artery and the levels of EMPs.Methods:Flow cytometry was used to measure the levels of circulating CD144+/CD42b-EMP> CD62E+EMP and CD105+EMP in30patients with KD (including30patients in acute phase,28patients in subacute phase, and40patients in convalescence phase) and24patients as control groups (including one group of12healthy children and the other group with12patients suffering fever-of-unknown). And the patients in the convalescence with KD were separated into two subgroups based on whether their coronary arterial lesion occurred or not. The correlations between the level of EMPs and FMD of brachial artery in KD patients were also investigated.Results:①Compared with healthy, KD patients in acute, subacute and convalescence phase had significantly higher proportions of CD144+/CD42b-EMP、CD62E+EMP and higher absolute numbers of CD144+/CD42b-EMP、CD62E+EMP and CD105+EMP (χ29.42,21.88, χ2=27.97,20.23,18.66, all P<0.05), while the proportion of CD105+EMP had no significant difference (χ2=2.16, P=0.70). Except the proportion of CD62E+EMP in acute phase, the otherwise levels of EMPs had no significant difference with fever group.③In the convalescence phase of KD, there were no statistical difference in the levels of EMPs between the two subgroups based on whether coronary artery lesion occurred or not.④In multiple linear regression analysis, grouping, CAL patient and absolute number of EMPs were significant determinants of FMD, and there were also significant negative correlations between the values of FMD and EMPs in all groups after adjustment of grouping and CAL (r=-0.312,-0.341,-0.293, P=0.004,0.002,0.008).Conclusion:The increased levels of EMPs are highly correlated with the decreasing values of FMD of brachial artery in the KD patients in acute, subcute and convalescence phases, and the levels of EMPs in the patients with KD are feasibly applied to evaluate vascular endothelial dysfunction.