Pediatric Cardiology

, Volume 38, Issue 5, pp 1057–1064 | Cite as

Z-score of Mitral Annular Plane Systolic Excursion is a Useful Indicator of Evaluation of Left Ventricular Function in Patients with Acute-Phase Kawasaki Disease

Original Article


We previously reported the clinical usefulness of the mitral annular plane systolic excursion (MAPSE) to evaluate the left ventricular (LV) function in patients with Kawasaki disease (KD) in the acute-phase. However, the feasibility of the MAPSE z-score has not been evaluated in patients with acute KD. We prospectively studied 60 KD patients without coronary aneurysms. The MAPSE z-scores were calculated using our standard MAPSE data. Brain natriuretic peptide (BNP) was measured as a parameter of LV function. In total, 281 healthy age- and body size-matched subjects were chosen as the control group. The MAPSE z-score decreased in the acute-phase (median value, −1.4) and increased in the convalescent phase (median value, 0.18; P < 0.0001). However, there was no significant difference in the MAPSE z-score between patients in the convalescent phase and the control patients (0.18 vs. 0.02, P = 0.199). Multivariate regression analysis revealed that BNP was an independent predictor of the MAPSE z-score (β = 0.40, P < 0.005). According to the receiver operating characteristic (ROC) analysis, the optimal cutoff value for the MAPSE z-score to judge LV dysfunction was −0.9. The MAPSE z-score is a useful index to evaluate LV function, and the cutoff value of −0.9 can be an indicator to judge LV dysfunction in the patients with acute-phase KD.


Kawasaki disease Left ventricular function Brain natriuretic peptide 


Compliance with Ethical Standards

Conflict of interest

Ikuo Hashimoto and Kazuhiro Watanabe declare that they have no conflict of interest.

Ethical Approval

This study complied with all institutional guidelines related to patient confidentiality and research ethics, and was approved by the institutional review board. 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. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of pediatricsToyama City HospitalToyama CityJapan
  2. 2.Department of pediatricsKurobe City HospitalKurobeJapan

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