Endothelial dysfunction by flow-mediated dilation assessed ultrasonically in patients with Kawasaki Disease

Kawasaki Disease (KD) is a febrile disorder seen in infants and young children. One of the most serious complications of the disease is coronary aneurysm. Endothelial dysfunction is considered to underlie the etiopathology of coronary aneurysm. Flow-mediated dilation (FMD), as assessed ultrasonically, is used to observe the endothelial function. The current paper summarizes, by providing a systematic review, the clinical studies that have examined endothelial dysfunction by determining the FMD ultrasonically in patients with KD. A PubMed-based search found eight articles published until 2013. Six studies reported the FMD level to be significantly lower in the patients with KD compared to controls, while two studies reported no significant difference in the FMD level between those with and without KD. Although patients with KD appeared to have endothelial dysfunction in the current summary, most reports have been associated with limitations, such as a small size and no prospective design for vascular outcomes. Further studies are therefore needed to draw definite conclusions regarding whether patients with KD suffer from endothelial dysfunction as determined by the FMD and/or whether this determination can be useful for understanding and managing vascular complications in these patients.