ASSESSMENT OF EFFECTS OF INTRAVENOUS DIPYRIDAMOLE ON REGIONAL MYOCARDIAL PERFUSION IN CHILDREN WITH KAWASAKI-DISEASE WITHOUT ANGIOGRAPHIC EVIDENCE OF CORONARY STENOSIS USING POSITRON EMISSION TOMOGRAPHY AND (H2O)-O-15

Background: Positron emission tomography and (H2O)-O-15 were used to c haracterize regional myocardial blood flow and distribution at rest an d in response to dipyridamole in children with Kawasaki disease but wi thout angiographic evidence of coronary stenosis. Method: Patients wer e classified into two groups on the basis of the results of selective coronary angiography: subjects in group I had normal coronary angiogra ms (n = 4): subjects in group II had aneurysms (n = 5). Results: Myoca rdial perfusion, assessed with (H2O)-O-15, was homogeneous over all re gions at rest and at peak flow in groups I and II. Dipyridamole infusi on significantly reduced myocardial perfusion reserve in group II (ave rage 3.56+/-1.03 fold versus 5.06+/-1.37 fold in group I, P < 0.001). Conclusion: Our results suggest that aneurysms associated with Kawasak i disease may reduce myocardial reserve. Non-invasive quantitative ass essment of myocardial blood flow with positron emission tomography and (H2O)-O-15 was useful in assessing the functional capacity of coronar y artery lesions and the extent of myocardial damage in children with Kawasaki disease.