Pediatric Cardiology

, Volume 37, Issue 2, pp 322–329 | Cite as

Elevated Inducible Nitric Oxide Levels and Decreased Hydrogen Sulfide Levels Can Predict the Risk of Coronary Artery Ectasia in Kawasaki Disease

  • Ruixia Song
  • Guiying LiuEmail author
  • Xiaohui LiEmail author
  • Wenya Xu
  • Jia Liu
  • Hongfang Jin
Original Article


Kawasaki disease (KD) is a vasculitis disease in children that is associated with coronary artery ectasia (CAE). We investigated whether inducible nitric oxide synthase (i-NOS) and hydrogen sulfide (H2S) could be used to predict CAE secondary to KD. We enrolled 65 children with KD (35 cases with CAE and 30 cases without CAE), 33 healthy children, and 32 children with fever but without vasculitis disease (febrile group). We measured plasma nitric oxide (NO), total nitric oxide synthase (Total-NOS), i-NOS, constructive nitric oxide synthase (c-NOS) levels, and H2S content in all patients. Plasma NO, Total-NOS, i-NOS, and H2S were higher in KD children than in healthy and febrile children (P < 0.05). The i-NOS level was higher in KD children with CAE compared to those without CAE, while the H2S was lower (both P < 0.05). Using a combination of i-NOS (higher than 10 U/mL) and H2S (lower than 3.31 μmol/L) to predict CAE had 80 % sensitivity and 81 % specificity (P < 0.05). Elevated plasma i-NOS and decreased plasma H2S levels in the acute phase of KD have good predictive value for CAE and may be used to guide appropriate clinical treatment and prevent future cardiovascular complications.


Kawasaki disease Inducible nitric oxide synthase Hydrogen sulfide Coronary artery ectasia 



Area under the curve


Coronary artery ectasia






Constructive nitric oxide synthase


Ethylenediamine tetraacetic acid


Hydrogen sulfide


Inducible nitric oxide synthase


Kawasaki disease




Sodium hydrosulfide


Nitric oxide


Nitric oxide synthase


Superoxide anion


Hydroxyl radical


Receiver operating characteristic curve


Total nitric oxide synthase



This study was funded by the science foundation for Beijing Scientific Research and Technology Project (Z131100006813024), which was given to Guiying Liu.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This research had acquired the approval from the Ethics Committee of Beijing Anzhen Hospital, China. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Before the experiment, informed consent from each patients’ parent or guardian was obtained.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Cardiovascular DiseasesChildren’s Hospital Affiliated to Capital Institute of PediatricsBeijingChina
  2. 2.Department of PediatricsBeijing Anzhen HospitalBeijingChina
  3. 3.Department of PediatricsPeking University First HospitalBeijingChina

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