Angiogenesis in fatal acute Kawasaki disease coronary artery and myocardium

A. F. Freeman*, S. E. Crawford, M. L. Cornwall, F. L. Garcia, Stanford T Shulman, Anne H Rowley

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Angiogenesis has been shown to be dysregulated in coronary artery (CA) aneurysms in the chronic phase of Kawasaki disease (KD). Neovascularization may occur in inflammatory-related vascular diseases because many angiogenesis mediators are secreted by inflammatory cells. We hypothesized that inflammation of the acute KD CA aneurysm could lead to dysregulation of angiogenesis mediators and subsequent neovascularization. To investigate this hypothesis, acute fatal KD cardiac tissues were immunostained for angiogenic inducers and inhibitors. Microvessel density was determined and the degree of inflammation assessed. Marked inflammation and angiogenesis were found in acute KD CA aneurysms and myocardium, with the highest microvessel density seen in patients who died 2-3 weeks after onset of the disease. Expression of proangiogenic proteins was higher than expression of inhibitors in KD CA aneurysms and myocardium. Angiogenesis mediators were localized to inflammatory cells in the myointima, adventitia, and myocardium. We conclude that significant neovascularization occurs in acute KD CA aneurysms and myocardium much sooner after onset of the disease than has been previously reported, that multiple angiogenesis factors are involved, and that dysregulation of angiogenesis likely contributes to KD vasculopathy.

Original languageEnglish (US)
Pages (from-to)578-584
Number of pages7
JournalPediatric cardiology
Issue number5
StatePublished - Oct 2005


  • Angiogenesis
  • Coronary artery aneurysm
  • Kawasaki disease

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine


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