Serial Exercise Testing and Echocardiography Findings of Patients With Kawasaki Disease

Ko-Long Lin; I-Hsiu Liou; Guan-Bo Chen; Shu-Fen Sun; Ken-Pen Weng; Chien-Hui Li; Sheng-Hui Tuan

doi:10.3389/fped.2022.847343

Serial Exercise Testing and Echocardiography Findings of Patients With Kawasaki Disease

Front Pediatr. 2022 Mar 23:10:847343. doi: 10.3389/fped.2022.847343. eCollection 2022.

Authors

Ko-Long Lin^{1

2

3}, I-Hsiu Liou¹, Guan-Bo Chen⁴, Shu-Fen Sun^{1

3}, Ken-Pen Weng^{3

5}, Chien-Hui Li⁶, Sheng-Hui Tuan^{7

6}

Affiliations

¹ Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan.
² School of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
³ School of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
⁴ Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung City, Taiwan.
⁵ Congenital Structural Heart Disease Center, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan.
⁶ Department of Rehabilitation Medicine, Cishan Hospital, Ministry of Health and Welfare, Kaohsiung City, Taiwan.
⁷ Institute of Allied Health Sciences, National Cheng Kung University, Tainan City, Taiwan.

Abstract

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.

Keywords: Kawasaki disease; adolescence; cardiopulmonary function; childhood; coronary artery Z score; exercise testing; oxygen consumption.