title: Increased plasma type B natriuretic peptide in the acute phase of Kawasaki disease.
abstract: BACKGROUND
  The aim of this study was to identify possible factors associated with type-B natriuretic peptide (BNP) production in the acute phase of Kawasaki disease (KD).
  
  
  METHODS
  Subjects were 54 patients with KD (KD group [KDG]) and 18 age-matched controls (control group [CG]). We evaluated left ventricular function using multi-modal echocardiography and determined blood chemistry including BNP, white blood cell count, C-reactive protein (CRP), and interleukin (IL)-6 in the KDG. We compared echocardiographic parameters between the KDG and the CG and determined the correlation between log (BNP) and echocardiographic parameters, white blood cell count, CRP, and IL-6 in the KDG.
  
  
  RESULTS
  The KDG showed high BNP (169.6 ± 529.6 pg/ml) despite preserved left ventricular function indicated by no significant difference in left ventricular ejection fraction (72.2 ± 9.2 vs 71.2 ± 7.8 %), z-score of left ventricular diastolic dimension (0.8 ± 1.3 vs 0.9 ± 0.8 SD), and Tei index (0.29 ± 0.09 vs 0.30 ± 0.06) between the KDG and the CG. However, left ventricular ejection fraction (r =-0.44, P= .001) and left ventricular end-diastolic dimension (r = 0.30, P < .05) significantly correlated with log (BNP). On the other hand, the KDG showed high CRP (89.7 ± 55.6 mg/l) and high IL-6 (242.2 ± 243.5 pg/ml), and CRP (r = 0.60, P < 0.0001) and IL-6 (r = 0.78, P < 0.0001) significantly correlated with log (BNP). Multiple stepwise regression analysis identified IL-6 (r = 0.77, P < 0.0001) most significantly correlated with log (BNP).
  
  
  CONCLUSIONS
  In acute KD, BNP significantly increases, despite well-preserved global left ventricular function, and inflammation might be associated with this increased BNP.
authors.affiliation: Department of Pediatrics and Child HealthCardiovascular Research InstituteCognitive and Molecular Research Institute of Brain Disease, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Kishimoto
authors.affiliation: Department of Pediatrics and Child HealthCardiovascular Research InstituteCognitive and Molecular Research Institute of Brain Disease, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Suda
authors.affiliation: Department of Pediatrics and Child HealthCardiovascular Research InstituteCognitive and Molecular Research Institute of Brain Disease, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Yozo
authors.initials: Y
authors.lastname: Teramachi
authors.affiliation: Department of Pediatrics and Child HealthCardiovascular Research InstituteCognitive and Molecular Research Institute of Brain Disease, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishino
authors.affiliation: Department of Pediatrics and Child HealthCardiovascular Research InstituteCognitive and Molecular Research Institute of Brain Disease, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kudo
authors.affiliation: Department of Pediatrics and Child HealthCardiovascular Research InstituteCognitive and Molecular Research Institute of Brain Disease, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Haruka
authors.initials: H
authors.lastname: Ishii
authors.affiliation: Department of Pediatrics and Child HealthCardiovascular Research InstituteCognitive and Molecular Research Institute of Brain Disease, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Motofumi
authors.initials: M
authors.lastname: Iemura
authors.affiliation: Department of Pediatrics and Child HealthCardiovascular Research InstituteCognitive and Molecular Research Institute of Brain Disease, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Pediatrics and Child HealthCardiovascular Research InstituteCognitive and Molecular Research Institute of Brain Disease, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Okamura
authors.affiliation: Department of Pediatrics and Child HealthCardiovascular Research InstituteCognitive and Molecular Research Institute of Brain Disease, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Toyojiro
authors.initials: T
authors.lastname: Matsuishi
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D013318:Stroke Volume; D016277:Ventricular Function, Left
chemical_list: D015850:Interleukin-6; D020097:Natriuretic Peptide, Brain