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Natriuretic peptide as an adjunctive diagnostic test in the acute phase of Kawasaki disease

Nagib Dahdah1, Ana Siles, Anne Fournier

  • 1Division of Pediatric Cardiology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, 3175 Côte Sainte-Catherine, Montréal, QC H3T 1C5, Canada. ndahdah@pol.net

Pediatric Cardiology
|April 15, 2009
PubMed

Insights

N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a superior marker for myocardial involvement in acute Kawasaki disease (KD) compared to B-type natriuretic peptide (BNP). This finding supports NT-proBNP as a valuable adjunctive diagnostic tool for KD.

Area of Science:

  • Pediatrics
  • Cardiology
  • Biochemistry

Background:

  • Kawasaki disease (KD) diagnosis typically emphasizes coronary arteritis over myocardial involvement.
  • Current diagnostic criteria and biomarkers often overlook cardiac-specific markers.
  • There is a need to evaluate cardiac biomarkers for improved KD diagnosis.

Purpose of the Study:

  • To assess the clinical utility of measuring B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) at the onset of KD.
  • To evaluate blood concentrations of BNP and NT-proBNP during the acute and subacute phases of KD.

Main Methods:

  • A prospective study compared newly diagnosed KD patients with non-KD febrile controls.
  • Blood samples were collected at presentation, post-intravenous immunoglobulin (IVIG) therapy, and during follow-up.
  • Analyzed NT-proBNP and BNP levels in 43 KD patients and 19 controls.

Main Results:

  • Pre-IVIG NT-proBNP levels were significantly higher in KD patients than controls (p < 0.001).
  • BNP levels showed no significant difference between KD patients and controls (p = 0.112).
  • NT-proBNP demonstrated higher sensitivity as a marker for myocardial involvement in acute KD.

Conclusions:

  • NT-proBNP is a more effective marker of myocardial involvement in acute KD than BNP.
  • NT-proBNP may serve as a valuable adjunctive diagnostic method, especially for KD cases with incomplete criteria.

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