Premium
Cardiac function on 3‐D speckle tracking imaging and cytokines in Kawasaki disease
Author(s) -
Kato Masataka,
Ayusawa Mamoru,
Watanabe Hirofumi,
Komori Akiko,
Abe Yuriko,
Nakamura Takahiro,
Kamiyama Hiroshi,
Takahashi Shori
Publication year - 2018
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/ped.13521
Subject(s) - medicine , cardiac function curve , ejection fraction , natriuretic peptide , cardiology , tumor necrosis factor alpha , kawasaki disease , acute phase protein , receptor , cytokine , heart failure , inflammation , artery
Background Serum N ‐terminal pro‐brain natriuretic peptide ( NT ‐pro BNP ) tends to rise in acute phase Kawasaki disease ( KD ), but the cause of NT ‐pro BNP elevation has not been clarified. In a previous study, cardiac function evaluated on 2‐D echocardiography (2D‐E) such as ejection fraction was normal, but this does not reflect subtle changes in cardiac dysfunction, and hence the association between cardiac function and NT ‐pro BNP elevation is still controversial. The aim of this study was therefore to elucidate the influence of cardiac function on NT ‐pro BNP elevation, by evaluating cardiac function via strain on 3‐D speckle tracking imaging (3D‐ STI ), in acute and subacute KD patients. Given that cytokines are also thought to induce NT ‐pro BNP in acute phase KD , serum cytokines and cytokine receptors were measured at the same time. Methods Laboratory data and echocardiography in 52 KD patients in the acute and subacute phases were reviewed. Results Median NT ‐pro BNP was significantly elevated in the acute phase compared with the subacute phase (356.5 pg/mL; IQR , 145–904 pg/mL vs 103.5 pg/mL; IQR , 59–150 pg/mL, P < 0.01). All cytokines were also significantly elevated in the acute phase compared with the subacute phase. Tumor necrosis factor ( TNF )‐α, soluble TNF receptor ( sTNFR )1, and sTNFR 2 concentration were all significantly higher in the acute phase. Indices of cardiac function were not significant different between phases. NT ‐pro BNP in the acute and subacute phases correlated with sTNFR 1 ( r = 0.63/0.43, P < 0.01), sTNFR 2 ( r = 0.50/0.31, P < 0.05), and interleukin‐6 ( r = 0.58/0.43, P < 0.01). NT ‐pro BNP did not correlate with global longitudinal strain (GLS) on 3D‐STI. Conclusion Although no correlation was seen between NT ‐pro BNP and GLS on 3D‐ STI , correlations between NT ‐pro BNP and cytokines were clear. NT ‐pro BNP might be a marker of inflammation in KD , but is not a marker of cardiac function.