Abstract:
INTRODUCTION:Corticosteroid administration in Kawasaki disease (KD) is controversial but accepted as treatment for patients who do not respond to initial treatment. The impact of corticosteroids on evolving coronary artery aneurysms (CAA) and future vascular remodelling is unknown. METHODS AND RESULTS:The clinical history of 80 patients (73% male; median age at diagnosis 2.2 years) seen from 1990 to 2008 with CAAs after KD were reviewed, 19 (24%) of whom received systemic corticosteroids in the acute phase (14 for ≤ 3 days, 5 for 4+ days). CAA z-scores were assessed at baseline, 2-3 months, and 1 year after the acute phase. Linear regression models adjusted for repeated measures were used to determine the association between change in CAA z-score over time and corticosteroid use, adjusting for patient age at diagnosis, gender, intravenous immunoglobulin use, total days of fever, albumin level, hemoglobin level and platelet count. RESULTS:The corticosteroid treated group had longer duration of fever in the acute phase (median 17 vs. 11 days, p=0.04). Adjusted CAA z-scores at diagnosis, 2-3 months and 1 year follow-up for CAA in the left anterior descending decreased (from +5.5 to +3.5 to +1.9) in those not treated with corticosteroids, but progressed for those treated with corticosteroids (from +7.4 to +17.5 to +15.8), regardless of duration of corticosteroid treatment. Similar results were noted for CAA of the right coronary artery and the left main coronary artery. CONCLUSIONS:The use of corticosteroids in the acute phase of KD for patients with evolving CAAs may be associated with worsening involvement and impaired vascular remodelling and warrants further study.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Millar K,Manlhiot C,Yeung RS,Somji Z,McCrindle BWdoi
10.1016/j.ijcard.2010.08.070subject
Has Abstractpub_date
2012-01-12 00:00:00pages
9-13issue
1eissn
0167-5273issn
1874-1754pii
S0167-5273(10)00660-1journal_volume
154pub_type
杂志文章abstract:OBJECTIVES:Systemic scleroderma (SSc) is a rare connective tissue disease presenting with fibrosis affecting skin and internal organs. Cardiovascular magnetic resonance (CMR) with quantification of extracellular volume (ECV) and T1 mapping might help to detect heart involvement. We aimed to evaluate whether myocardial ...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2017.08.072
更新日期:2017-12-15 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,meta分析,评审
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更新日期:2012-06-28 00:00:00
abstract::Acute myocardial infarction during pregnancy is rare but may be associated with high risk complications. We present a very rare case about an acute myocardial infarction with anterior ST elevation in a 40-year-old woman, at 38th week of gestational period. The coronary arteriograms showed a diffuse left coronary vasos...
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journal_title:International journal of cardiology
pub_type: 杂志文章,meta分析,评审
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abstract::Increasing survival rates for patients with congenital heart disease (CHD) represent a major achievement of modern medicine. Despite incredible progress been made in diagnosis, follow-up, early treatment and management in adulthood, many patients are faced with long-term complications, such as arrhythmia, thromboembol...
journal_title:International journal of cardiology
pub_type: 杂志文章,评审
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journal_title:International journal of cardiology
pub_type: 杂志文章,多中心研究
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更新日期:2013-10-12 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,随机对照试验
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更新日期:2013-10-03 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件
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journal_title:International journal of cardiology
pub_type: 杂志文章,meta分析
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更新日期:2018-08-15 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,评审
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journal_title:International journal of cardiology
pub_type: 杂志文章
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2017.05.030
更新日期:2017-08-15 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/s0167-5273(99)00063-7
更新日期:1999-07-31 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2007.11.007
更新日期:2009-04-03 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2017.04.084
更新日期:2017-08-15 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2019.11.096
更新日期:2020-02-15 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,meta分析
doi:10.1016/j.ijcard.2019.07.056
更新日期:2019-12-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2020.11.039
更新日期:2020-11-23 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件
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更新日期:2007-03-02 00:00:00
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journal_title:International journal of cardiology
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doi:10.1016/j.ijcard.2016.10.110
更新日期:2017-01-15 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
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journal_title:International journal of cardiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ijcard.2017.10.063
更新日期:2018-01-15 00:00:00
abstract::The purpose of the present study was to assess whether the insertion (I)/deletion (D) polymorphism of the angiotensin converting enzyme (ACE) gene, and the polymorphism of angiotensinogen (AGT) gene with threonine (T) instead of methionine (M) at amino acid 235 in exon 2 (M235T) were associated with left ventricular d...
journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:1996-03-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件,多中心研究
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更新日期:2010-11-05 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2010.02.047
更新日期:2010-11-19 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2017.03.147
更新日期:2017-08-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,评审
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更新日期:2010-06-11 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2017.02.148
更新日期:2017-06-01 00:00:00
abstract::Left ventricular non-compaction (LVNC) is a rare disorder that results in multiple deep trabeculations within the left ventricular myocardium. It is thought to be due in part, to an arrest of myocardial development but more recent evidence suggests that some cases may actually be acquired while other isolated cases ha...
journal_title:International journal of cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.ijcard.2009.07.003
更新日期:2010-04-15 00:00:00
abstract:BACKGROUND:Exercise intolerance is a widespread and serious problem in chronic heart failure (CHF) patients. However, the impact of a supervised exercise and rehabilitation program on exercise tolerance and cardiac performance in severe CHF patients has not yet been fully investigated. METHODS:Of 56 consecutive patien...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2006.03.021
更新日期:2007-04-04 00:00:00