Do Kawasaki disease patients without coronary artery abnormalities need a long-term follow-up? A myocardial single-photon emission computed tomography pilot study

Objective: To determine the frequency and risk factors for long-term myocardial perfusion scintigraphy abnormalities in patients with Kawasaki disease (KD). Methods: A cohort of patients with KD at least 3 years after disease onset and with persistent coronary artery aneurysms (CAA) (group 1) or without CAA (group 2) underwent stress-rest myocardial single-photon emission computed tomography (SPECT). Clinical and laboratory parameters at disease onset were considered to assess their predictive value for the development of myocardial perfusion abnormalities. Results: Forty patients, 20 in group 1 and 20 in group 2, entered the study. The two groups turned out to be comparable for demographic, clinical and laboratory characteristics. Five patients (12.5%), two in group 1 and three in group 2, had abnormal myocardial perfusion assessed by SPECT. Neither the presence of CAA nor the overall cardiac involvement at the disease onset significantly increased the risk for these abnormalities. Conclusion: Cardiac SPECT abnormalities are not unusual in KD and can be found in patients with or without CAA. If confirmed in a larger cohort of patients, these preliminary data indicate that careful long-term cardiac follow-up should be considered, regardless of the presence of CAA.