Pediatric Cardiology

, Volume 30, Issue 6, pp 810–817

Natriuretic Peptide as an Adjunctive Diagnostic Test in the Acute Phase of Kawasaki Disease

  • Nagib Dahdah
  • Ana Siles
  • Anne Fournier
  • Jocelyne Cousineau
  • Edgard Delvin
  • Claire Saint-Cyr
  • Linda Spiegelblatt
  • Yvette Bonny
  • Michèle Vartian
  • Martine Montigny
Original Article

DOI: 10.1007/s00246-009-9441-2

Cite this article as:
Dahdah, N., Siles, A., Fournier, A. et al. Pediatr Cardiol (2009) 30: 810. doi:10.1007/s00246-009-9441-2

Abstract

Coronary arteritis rather than myocardial involvement is typically emphasized in Kawasaki disease (KD). Moreover, the criteria and the usual biological markers oversee the importance of cardiac-specific markers in diagnosing this disease. We sought to study the clinical usefulness of measuring B-type natriuretic peptide (BNP) and its N-terminal moiety (NT-proBNP) at the onset of KD. Our objective was to evaluate blood concentrations of BNP and NT-proBNP during the acute and subacute phases of KD. We conducted a prospective study comparing newly diagnosed KD patients to non-KD febrile controls. Blood specimens were collected at presentation, 6–12 h after intravenous immunoglobulin (IVIG) therapy, 1–2 weeks later, and 2–3 months later, or only upon reenrollment for controls. Forty-there KD and 19 control patients were enrolled consecutively. The mean age was 47.1 ± 34.3 and 62.2 ± 44.9 months, respectively (p = NS). Pre-IVIG NT-proBNP levels were significantly higher in KD patients than in controls (923.6 ± 1361.7 vs. 186.2 ± 198.0 ng/L; p < 0.001), with no statistical difference for BNP (141.9 ± 227.5 vs. 59.9 ± 72.4 ng/L; p = 0.112). In conclusion, our data indicate that NT-proBNP is a better marker of myocardial involvement in acute KD than BNP, particularly in cases with incomplete diagnostic criteria, and suggest that it may be a valid adjunctive diagnostic method to support the diagnosis of KD.

Keywords

B-type natriuretic peptide (BNP) N-terminal moiety of BNP (NT-proBNP) Carditis Myocardial dysfunction 

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Nagib Dahdah
    • 1
  • Ana Siles
    • 1
  • Anne Fournier
    • 1
  • Jocelyne Cousineau
    • 2
  • Edgard Delvin
    • 2
  • Claire Saint-Cyr
    • 3
  • Linda Spiegelblatt
    • 4
  • Yvette Bonny
    • 4
  • Michèle Vartian
    • 5
  • Martine Montigny
    • 5
  1. 1.Division of Pediatric Cardiology, Department of PediatricsCentre Hospitalier Universitaire Sainte-Justine, Université de MontréalMontréalCanada
  2. 2.Department of Clinical BiochemistryCentre Hospitalier Universitaire Sainte-Justine, Université de MontréalMontréalCanada
  3. 3.Division of Rheumatology and Immunology, Department of PediatricsCentre Hospitalier Universitaire Sainte-Justine, Université de MontréalMontréalCanada
  4. 4.Department of PediatricsHôpital Maisonneuve-Rosemont, Université de MontréalMontréalCanada
  5. 5.Hôpital de la Cité-de-la-SantéLavalCanada

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