Document Detail


Alleviation of myocardial ischemia after Kawasaki disease by heparin and exercise therapy.
MedLine Citation:
PMID:  11382729     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Heparin promotes angiogenesis. We evaluated the effects of combined treatment with heparin and exercise on myocardial ischemia in the chronic stage of Kawasaki disease. METHODS AND RESULTS: This study was conducted in 7 patients (aged 6 to 19 years) who had a totally occluded coronary artery and stress-induced myocardial ischemia in the collateral-dependent areas. Twice-daily exercise using a bicycle ergometer was performed with increments of 0.5 W/kg every 3 minutes up to maximal exertion for 10 days. Heparin, which immediately increased circulating hepatocyte growth factor, was given intravenously 10 minutes before each exercise period. Newly developed myocardial infarction, ventricular tachyarrhythmia, anginal attack, or hemorrhagic complication was not observed in any patient. Dipyridamole-loading single photon emission computed tomography documented improved myocardial perfusion in the collateral-dependent areas and a significant reduction in total defect scores in all patients after the completion of 20 sessions (P=0.01). In control patients who did not receive the heparin-exercise therapy, however, stress defect scores remained unchanged (n=1) or increased (n=2) during follow-up. Computerized quantitative coronary angiography provided evidence that the heparin-exercise therapy increased the diameter of the occluded artery to which collaterals terminated (P=0.001) but not that of the reference artery with which collaterals were not connected (P=0.96). CONCLUSIONS: The findings suggest that a series of heparin and exercise treatments over 10 days may have a dramatic effect on the alleviation of myocardial ischemia in collateral-dependent regions. This may be a safe, noninvasive revascularization therapy for patients with coronary artery occlusion in the chronic stage of Kawasaki disease.
Authors:
S Tateno; M Terai; K Niwa; T Jibiki; H Hamada; K Yasukawa; T Honda; S Oana; Y Kohno
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  103     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-30     Completed Date:  2001-07-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2591-7     Citation Subset:  AIM; IM    
Affiliation:
Departments of Pediatrics, Chiba University School of Medicine, Chiba Cardiovascular Center, Chiba, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anticoagulants / therapeutic use*
Child
Coronary Angiography
Coronary Vessels / pathology,  physiopathology
Exercise Therapy*
Female
Heparin / therapeutic use*
Humans
Male
Mucocutaneous Lymph Node Syndrome / complications*
Myocardial Ischemia / etiology,  therapy*
Tomography, Emission-Computed, Single-Photon
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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