Korean Circ J.  2015 Jul;45(4):317-324. 10.4070/kcj.2015.45.4.317.

Cardiac Function in Kawasaki Disease Patients with Respiratory Symptoms

• Lee SB
• Choi HS
• Son S
• Hong YM

• KMID: 1964104
• DOI: http://doi.org/10.4070/kcj.2015.45.4.317

Abstract

BACKGROUND AND OBJECTIVES
Respiratory symptoms are often observed in children with Kawasaki disease (KD) during the acute phase. The association of respiratory viruses in children with KD was investigated using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) and tissue Doppler echocardiography.
SUBJECTS AND METHODS
138 KD patients were included from January 2010 to June 2013. We compared 3 groups (group 1: n=94, KD without respiratory symptoms; group 2: n=44, KD with respiratory symptoms; and group 3: n=50, febrile patients with respiratory symptoms). Laboratory data were obtained from each patient including N-terminal pro-brain natriuretic peptide (NT-proBNP). Echocardiographic measurements were compared between group 1 and group 2. RT-PCR was performed using nasopharyngeal secretion to screen for the presence of 14 viruses in groups 2 and 3.
RESULTS
The incidence of KD with respiratory symptoms was 31.8%. The duration of fever was significantly longer, and coronary artery diameter was larger in group 2 than in group 1. Tei index was significantly higher and coronary artery diameter larger in group 2 than group 1. Coronary artery diameter, C-reactive protein levels, platelet count, alanine aminotransferase levels, and NT-pro BNP levels were significantly higher and albumin levels lower in group 2 compared with group 3.
CONCLUSION
NT-pro BNP was a valuable diagnostic tool in differentiating KD from other febrile viral respiratory infections. Some viruses were more frequently observed in KD patients than in febrile controls. Tei index using tissue Doppler imaging was increased in KD patients with respiratory symptoms.

Keyword

Mucocutaneous lymph node syndrome; Reverse transcriptase polymerase chain reaction; Respiratory virus; Natriuretic peptide, brain; Echocardiography, Doppler

MeSH Terms

Alanine Transaminase
C-Reactive Protein
Child
Coronary Vessels
Echocardiography
Echocardiography, Doppler
Fever
Humans
Incidence
Mucocutaneous Lymph Node Syndrome*
Natriuretic Peptide, Brain
Platelet Count
Respiratory Tract Infections
Reverse Transcriptase Polymerase Chain Reaction
Alanine Transaminase
C-Reactive Protein
Natriuretic Peptide, Brain

Figure

• 

  Fig. 1 Tei index using tissue Doppler imaging in Kawasaki disease patients. Tei index= (a-b)/b=(IVCT+IVRT)/ET. IVCT: isovolumetric contraction time, IVRT: isovolumetric relaxation time, ET: ejection time, LV Eject T: left ventricular ejection time, S': systolic myocardial velocity, A': late diastolic myocardial velocity, E': early diastolic myocardial velocity.

• 

  Fig. 2 Parasternal short axis echocardiographic imaging showing a dilated right coronary artery. RCA: right coronary artery.

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