164 - DOES CORONARY LESIONS LESS HAPPEN IN KAWASAKI DISEASE WITH MYOCARDITIS?

Background: Kawasaki disease(KD) is an acute febrile disease which causes systemic vasculitis, and is the most common cause of acquired heart disease in developed countries. KD patients with myocarditis whose left ventricular function is decreased on Echocardiography are known to have increased risks for coronary lesion due to severe systemic inflammation. However, in some patients with severe coronary lesion, left ventricular ejection fraction(LVEF) is well maintained. On the contrary, many KD patients with myocarditis show normal coronary arteries or transient coronary lesions.

Methods and Results: We compared the clinical characteristics of KD patients with myocarditis with that of KD patients without myocarditis. From 2006 to 2019, KD patients admitted to our hospital with LVEF less than 55% were 11 patients. Their average BNP level was 807.7pg/ml, which was significantly higher than without myocarditis group(p < 0.05) and the average LVEF was 47.2%, which was significantly lower. However, coronary lesion developed in 1/11 patient with myocarditis(9.1%), which was lower than without myocarditis group(23.6%). After exclusion of transient coronary lesion that normalized in 2 months of onset, 8.9% had coronary lesion which is not different from myocarditis group.
Conclusion: Although LVEF seems to be improved following intravenous immunoglobulin therapy, the pathophysiology of coronary lesion in KD patients seems to be different from that of myocarditis. Multicenter study may be needed to reveal risk factors of coronary lesion and myocarditis in KD.