title: Cardiac Function in Kawasaki Disease Patients with Respiratory Symptoms.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Seul Bee
authors.initials: SB
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Han Seul
authors.initials: HS
authors.lastname: Choi
authors.affiliation: Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Sejung
authors.initials: S
authors.lastname: Son
authors.affiliation: Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Young Mi
authors.initials: YM
authors.lastname: Hong
keywords: Echocardiography, Doppler; Mucocutaneous lymph node syndrome; Natriuretic peptide, brain; Respiratory virus; Reverse transcriptase polymerase chain reaction