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Impairment of Left Ventricular Longitudinal Contraction is Associated with Serum Brain Natriuretic Peptide Concentration in Patients with Acute-Phase Kawasaki Disease

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Abstract

It is well known that brain natriuretic peptide (BNP) is elevated in the acute phase of Kawasaki disease (KD). We hypothesized that mitral annular plane systolic excursion (MAPSE) could identify LV dysfunction in the acute phase of KD. Fifty patients with KD were enrolled in this study. BNP sampling and an echocardiographic study were performed just before and after intravenous immunoglobulin administration. MAPSE was measured in M-mode in the apical four-chamber view. The %MAPSE was calculated as the MAPSE measured in the acute phase divided by that measured in the convalescent phase. We compared the acute and the convalescent phases of KD. The values of the MAPSE were significantly reduced (45 out of 50 patients) during the acute phase and immediately recovered in the convalescent phase (10.0 ± 1.9 vs. 12.7 ± 1.9 mm, P < 0.0001). Of the parameters tested, %MAPSE was the only echocardiographic parameter that was associated with Log-BNP. Additionally, %MAPSE had a significant negative correlation with Log-BNP (r = −0.45, P < 0.0039). Longitudinal LV contraction is impaired in the acute phase of KD, but it immediately recovers in the convalescent phase. Measuring the longitudinal LV contractility should be essential for evaluating LV function in the acute phase of KD, and MAPSE is useful for this evaluation.

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References

  1. Ayusawa M, Sonobe T, Uemura S, Ogawa S, Nakamura Y, Kiyosawa N, Ishii M, Harada K, Kawasaki Disease Research C (2005) Revision of diagnostic guidelines for Kawasaki disease (the 5th revised edition). Pediatr Int 47:232–234

    Article  PubMed  Google Scholar 

  2. Bang S, Yu JJ, Han MK, Ko HK, Chun S, Choi HS, Kim YH, Ko JK, Park IS (2011) Log-transformed plasma level of brain natriuretic peptide during the acute phase of Kawasaki disease is quantitatively associated with myocardial dysfunction. Korean J Pediatr 54:340–344

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Bergenzaun L, Ohlin H, Gudmundsson P, Willenheimer R, Chew MS (2013) Mitral annular plane systolic excursion (MAPSE) in shock: a valuable echocardiographic parameter in intensive care patients. Cardiovasc Ultrasound 11:16

    Article  PubMed Central  PubMed  Google Scholar 

  4. Burns JC, Glodé MP (2004) Kawasaki syndrome. Lancet 364:533–544

    Article  PubMed  Google Scholar 

  5. Cho SY, Kim Y, Cha SH, Suh JT, Han MY, Lee HJ (2011) Adjuvant laboratory marker of Kawasaki disease; NT-pro-BNP or hs-CRP? Ann Clin Lab Sci 41:360–363

    CAS  PubMed  Google Scholar 

  6. Dahdah N, Siles A, Fournier A, Cousineau J, Delvin E, Saint-Cyr C, Spiegelblatt L, Bonny Y, Vartian M, Montigny M (2009) Natriuretic peptide as an adjunctive diagnostic test in the acute phase of Kawasaki disease. Pediatr Cardiol 30:810–817

    Article  PubMed  Google Scholar 

  7. Harada K (1991) Intravenous gamma-globulin treatment in Kawasaki disease. Acta Paediatr Jpn 33:805–810

    Article  CAS  PubMed  Google Scholar 

  8. Harada M, Yokouchi Y, Oharaseki T, Matsui K, Tobayama H, Tanaka N, Akimoto K, Takahashi K, Kishiro M, Shimizu T (2012) Histopathological characteristics of myocarditis in acute-phase Kawasaki disease. Histopathology 61:1156–1167

    Article  PubMed  Google Scholar 

  9. Hashimoto I, Watanabe K (2014) Alternation of right ventricular contraction pattern in healthy children. Circ J 78:1967–1973

    Article  PubMed  Google Scholar 

  10. Hu K, Liu D, Herrmann S, Niemann M, Gaudron PD, Voelker W, Ertl G, Bijnens B, Weidemann F (2013) Clinical implication of mitral annular plane systolic excursion for patients with cardiovascular disease. Eur Heart J Cardiovasc Imaging 14:205–212

    Article  PubMed  Google Scholar 

  11. Iwashima S, Ishikawa T (2013) B-type natriuretic peptide and N-terminal pro-BNP in the acute phase of Kawasaki disease. World J Pediatr 9:239–244

  12. Kaneko K, Yoshimura K, Ohashi A, Kimata T, Shimo T, Tsuji S (2011) Prediction of the risk of coronary arterial lesions in Kawasaki disease by brain natriuretic peptide. Pediatr Cardiol 32:1106–1109

    Article  PubMed  Google Scholar 

  13. Kawamura T, Wago M, Kawaguchi H, Tahara M, Yuge M (2000) Plasma brain natriuretic peptide concentrations in patients with Kawasaki disease. Pediatr Int 42:241–248

    Article  CAS  PubMed  Google Scholar 

  14. Kishimoto S, Suda K, Teramachi Y, Nishino H, Kudo Y, Ishii H, Iemura M, Takahashi T, Okamura H, Matsuishi T (2011) Increased plasma type B natriuretic peptide in the acute phase of Kawasaki disease. Pediatr Int 53:736–741

    Article  CAS  PubMed  Google Scholar 

  15. Kitabatake A, Inoue M, Asao M, Ito H, Masuyama T, Tanouchi J, Morita T, Hori M, Yoshima H, Ohnishi K, Abe H (1984) Noninvasive evaluation of the ratio of pulmonary to systemic flow in atrial septal defect by duplex Doppler echocardiography. Circulation 69:73–79

    Article  CAS  PubMed  Google Scholar 

  16. Koestenberger M, Nagel B, Ravekes W, Avian A, Heinzl B, Fritsch P, Fandl A, Rehak T, Gamillscheg A (2012) Left ventricular long-axis function: reference values of the mitral annular plane systolic excursion in 558 healthy children and calculation of z-score values. Am Heart J 164:125–131

    Article  PubMed  Google Scholar 

  17. Koteda Y, Suda K, Kishimoto S, Ito S, Kudo Y, Nishino H, Ishii H, Iemura M, Matuishi T (2009) Impact of intravenous immunoglobulin infusion on longitudinal left ventricular performance in patients with acute Kawasaki disease of usual course. J Cardiol 54:45–51

    Article  PubMed  Google Scholar 

  18. Kurotobi S, Kawakami N, Shimizu K, Aoki H, Nasuno S, Takahashi K, Kogaki S, Ozono K (2005) Brain natriuretic peptide as a hormonal marker of ventricular diastolic dysfunction in children with Kawasaki disease. Pediatr Cardiol 26:425–430

    Article  CAS  PubMed  Google Scholar 

  19. Lisi M, Ballo P, Cameli M, Gandolfo F, Galderisi M, Chiavarelli M, Henein MY, Mondillo S (2012) Mitral annular longitudinal function preservation after mitral valve repair: the MARTE study. Int J Cardiol 157:212–215

    Article  CAS  PubMed  Google Scholar 

  20. Matos J, Kronzon I, Panagopoulos G, Perk G (2012) Mitral annular plane systolic excursion as a surrogate for left ventricular ejection fraction. J Am Soc Echocardiogr: Off Publ Am Soc Echocardiogr 25:969–974

    Article  Google Scholar 

  21. Matsubara T (1991) Interleukin 6 activities and tumor necrosis factor-alpha levels in serum of patients with Kawasaki disease. Arerugi (Allergy) 40:147–154

    CAS  Google Scholar 

  22. McCandless RT, Minich LL, Wilkinson SE, McFadden ML, Tani LY, Menon SC (2013) Myocardial strain and strain rate in Kawasaki disease. Eur Heart J Cardiovasc Imaging 14:1061–1068

    Article  PubMed  Google Scholar 

  23. McCrindle BW, Li JS, Minich LL, Colan SD, Atz AM, Takahashi M, Vetter VL, Gersony WM, Mitchell PD, Newburger JW, Pediatric Heart Network I (2007) Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements. Circulation 116:174–179

    Article  PubMed  Google Scholar 

  24. Ogawa T, de Bold AJ (2012) Uncoordinated regulation of atrial natriuretic factor and brain natriuretic peptide in lipopolysaccharide-treated rats. Biomarkers : Biochem Indic Expo Response Susceptibility Chem 17:140–149

    Article  CAS  Google Scholar 

  25. Pombo JF, Troy BL, Russell RO Jr (1971) Left ventricular volumes and ejection fraction by echocardiography. Circulation 43:480–490

    Article  CAS  PubMed  Google Scholar 

  26. Poterucha JT, Kutty S, Lindquist RK, Li L, Eidem BW (2012) Changes in left ventricular longitudinal strain with anthracycline chemotherapy in adolescents precede subsequent decreased left ventricular ejection fraction. J Am Soc Echocardiogr 25:733–740

    Article  PubMed  Google Scholar 

  27. Sato N, Sagawa K, Sasaguri Y, Inoue O, Kato H (1993) Immunopathology and cytokine detection in the skin lesions of patients with Kawasaki disease. J Pediatr 122:198–203

    Article  CAS  PubMed  Google Scholar 

  28. Suzuki H, Uemura S, Tone S, Iizuka T, Koike M, Hirayama K, Maeda J (1996) Effects of immunoglobulin and gamma-interferon on the production of tumour necrosis factor-alpha and interleukin-1 beta by peripheral blood monocytes in the acute phase of Kawasaki disease. Eur J Pediatr 155:291–296

    Article  CAS  PubMed  Google Scholar 

  29. Takeuchi D, Saji T, Takatsuki S, Fujiwara M (2007) Abnormal tissue doppler images are associated with elevated plasma brain natriuretic peptide and increased oxidative stress in acute Kawasaki disease. Circ J 71:357–362

    Article  CAS  PubMed  Google Scholar 

  30. Tanaka T, Kanda T, Takahashi T, Saegusa S, Moriya J, Kurabayashi M (2004) Interleukin-6-induced reciprocal expression of SERCA and natriuretic peptides mRNA in cultured rat ventricular myocytes. J Int Med Res 32:57–61

    Article  CAS  PubMed  Google Scholar 

  31. Teichholz LE, Cohen MV, Sonnenblick EH, Gorlin R (1974) Study of left ventricular geometry and function by B-scan ultrasonography in patients with and without asynergy. N Engl J Med 291:1220–1226

    Article  CAS  PubMed  Google Scholar 

  32. Torrent-Guasp F, Buckberg GD, Clemente C, Cox JL, Coghlan HC, Gharib M (2001) The structure and function of the helical heart and its buttress wrapping. I. The normal macroscopic structure of the heart. Semin Thorac Cardiovasc Surg 13:301–319

    Article  CAS  PubMed  Google Scholar 

  33. Yoshimura K, Kimata T, Mine K, Uchiyama T, Tsuji S, Kaneko K (2013) N-terminal pro-brain natriuretic peptide and risk of coronary artery lesions and resistance to intravenous immunoglobulin in Kawasaki disease. J Pediatr 162:1205–1209

    Article  CAS  PubMed  Google Scholar 

  34. Yu JJ, Choi HS, Kim YB, Son JS, Kim YH, Ko JK, Park IS (2010) Analyses of left ventricular myocardial deformation by speckle-tracking imaging during the acute phase of Kawasaki disease. Pediatr Cardiol 31:807–812

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Toyama City Hospital, 2-1 Hokubu Machi, Imaizumi, Toyama City, Toyama, Japan

    Ikuo Hashimoto, Kazuhiro Watanabe, Mako Okabe & Hisashi Kaneda

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  1. Ikuo Hashimoto
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  2. Kazuhiro Watanabe
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Correspondence to Ikuo Hashimoto.

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Hashimoto, I., Watanabe, K., Okabe, M. et al. Impairment of Left Ventricular Longitudinal Contraction is Associated with Serum Brain Natriuretic Peptide Concentration in Patients with Acute-Phase Kawasaki Disease. Pediatr Cardiol 36, 979–986 (2015). https://doi.org/10.1007/s00246-015-1108-6

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  • DOI: https://doi.org/10.1007/s00246-015-1108-6

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