Exercise tolerance test in Kawasaki patients without coronary lesions
4 affiliations
- 1Pediatric Cardiology, Children Medical Center, Tehran University of Medical Sciences
- 2Pediatric Rheumatology, Children Medical Center, Tehran University of Medical Sciences
- 3Medical Student, Children Medical Center, Tehran University of Medical Sciences
- 4Aliasghar Clinical Research Development Center, Department of Pediatrics, School of Medicine, Iran University of Medical Sciences
Abstract
Introduction Kawasaki disease (KD) is a systemic vasculitis of unknown origin and the leading cause of acquired heart disease in children in developed countries. If untreated, it can cause coronary artery damage in up to 25% of cases. Lifelong follow-up is essential, even for patients without obvious coronary lesions (risk level-I KD). Since some cardiac abnormalities may not be apparent at rest, stress testing offers valuable insight. This study aimed to evaluate exercise tolerance test (ETT) outcomes in children with a history of risk level-I KD compared to a control group. Materials and methods This case-control study included children aged 5–17 years with documented KD without coronary lesions and at least six months since disease onset. After ethics approval, participants underwent a standardized treadmill test (modified Bruce protocol). A control group of healthy children was also included; however, exact age-matched analysis was not possible due to recruitment constraints. Results Sixty children were divided equally into KD and control groups. The KD group had significantly lower mean age, height, weight, and BSA compared to the control group. After adjusting for these variables, most exercise indices showed no significant difference between groups, except for chronotropic incompetence which was more prevalent in the KD group. However, most differences became non-significant after adjusting for age and BMI. Conclusion Children with KD generally showed normal exercise tolerance, but a reduced chronotropic response may indicate subtle residual cardiac effects. These findings suggest a potential for subtle cardiac effects and may support the consideration of stress-based evaluation in select patients; however, further larger prospective studies are needed to confirm these observations.
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BibTeX
@article{aghaeimoghadam2026exercise,
title = {{Exercise tolerance test in Kawasaki patients without coronary lesions}},
author = {Ehsan Aghaei-Moghadam and Vahid Ziaee and Keyhan Sayadpour Zanjani and Fatemeh tahghighi Sharabian and Payman Sadeghi and Fatemeh HadavandKhani and Sadatinejad Seyyed Mohsen},
journal = {BMC Pediatrics},
year = {2026},
month = jul,
doi = {10.1186/s12887-026-07397-y},
url = {https://doi.org/10.1186/s12887-026-07397-y},
note = {CC BY},
}
RIS
TY - JOUR
TI - Exercise tolerance test in Kawasaki patients without coronary lesions
AU - Ehsan Aghaei-Moghadam
AU - Vahid Ziaee
AU - Keyhan Sayadpour Zanjani
AU - Fatemeh tahghighi Sharabian
AU - Payman Sadeghi
AU - Fatemeh HadavandKhani
AU - Sadatinejad Seyyed Mohsen
PY - 2026
DA - 2026/07/01
JO - BMC Pediatrics
DO - 10.1186/s12887-026-07397-y
UR - https://doi.org/10.1186/s12887-026-07397-y
AB - Introduction Kawasaki disease (KD) is a systemic vasculitis of unknown origin and the leading cause of acquired heart disease in children in developed countries. If untreated, it can cause coronary artery damage in up to 25% of cases. Lifelong follow-up is essential, even for patients without obvious coronary lesions (risk level-I KD). Since some cardiac abnormalities may not be apparent at rest, stress testing offers valuable insight. This study aimed to evaluate exercise tolerance test (ETT) outcomes in children with a history of risk level-I KD compared to a control group. Materials and methods This case-control study included children aged 5–17 years with documented KD without coronary lesions and at least six months since disease onset. After ethics approval, participants underwent a standardized treadmill test (modified Bruce protocol). A control group of healthy children was also included; however, exact age-matched analysis was not possible due to recruitment constraints. Results Sixty children were divided equally into KD and control groups. The KD group had significantly lower mean age, height, weight, and BSA compared to the control group. After adjusting for these variables, most exercise indices showed no significant difference between groups, except for chronotropic incompetence which was more prevalent in the KD group. However, most differences became non-significant after adjusting for age and BMI. Conclusion Children with KD generally showed normal exercise tolerance, but a reduced chronotropic response may indicate subtle residual cardiac effects. These findings suggest a potential for subtle cardiac effects and may support the consideration of stress-based evaluation in select patients; however, further larger prospective studies are needed to confirm these observations.
SN - 1471-2431
ER -