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Increased plasma type B natriuretic peptide in the acute phase of Kawasaki disease
Author(s) -
Kishimoto Shintaro,
Suda Kenji,
Teramachi Yozo,
Nishino Hiroshi,
Kudo Yoshiyuki,
Ishii Haruka,
Iemura Motofumi,
Takahashi Tomoyuki,
Okamura Hisayoshi,
Matsuishi Toyojiro
Publication year - 2011
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.2011.03351.x
Subject(s) - medicine , ejection fraction , natriuretic peptide , cardiology , brain natriuretic peptide , kawasaki disease , heart failure , artery
Background: The aim of this study was to identify possible factors associated with type‐B natriuretic peptide (BNP) production in the acute phase of Kawasaki disease (KD). Methods: Subjects were 54 patients with KD (KD group [KDG]) and 18 age‐matched controls (control group [CG]). We evaluated left ventricular function using multi‐modal echocardiography and determined blood chemistry including BNP, white blood cell count, C‐reactive protein (CRP), and interleukin (IL)‐6 in the KDG. We compared echocardiographic parameters between the KDG and the CG and determined the correlation between log (BNP) and echocardiographic parameters, white blood cell count, CRP, and IL‐6 in the KDG. Results: The KDG showed high BNP (169.6 ± 529.6 pg/ml) despite preserved left ventricular function indicated by no significant difference in left ventricular ejection fraction (72.2 ± 9.2 vs 71.2 ± 7.8 %), z‐score of left ventricular diastolic dimension (0.8 ± 1.3 vs 0.9 ± 0.8 SD), and Tei index (0.29 ± 0.09 vs 0.30 ± 0.06) between the KDG and the CG. However, left ventricular ejection fraction (r =−0.44, P = .001) and left ventricular end‐diastolic dimension (r = 0.30, P < .05) significantly correlated with log (BNP). On the other hand, the KDG showed high CRP (89.7 ± 55.6 mg/l) and high IL‐6 (242.2 ± 243.5 pg/ml), and CRP (r = 0.60, P < 0.0001) and IL‐6 (r = 0.78, P < 0.0001) significantly correlated with log (BNP). Multiple stepwise regression analysis identified IL‐6 (r = 0.77, P < 0.0001) most significantly correlated with log (BNP). Conclusions: In acute KD, BNP significantly increases, despite well‐preserved global left ventricular function, and inflammation might be associated with this increased BNP.