Research progress of nitrogen-terminal B-type natriuretic peptide and its clinical value in Kawasaki dis-ease / 国际儿科学杂志

ABSTRACT

Kawasaki disease ( KD) is an acute febrile illness that preferentially affects children youn-ger than 5 years old and the primary cause of acquired heart disease during childhood. Coronary artery aneu-rysms ( CAA) is a serious complication of KD, leading to ischemic heart disease, myocardial infarction, and sudden cardiac death. Timely initiation of treatment with intravenous immunoglobulin ( IVIG) has reduced the incidence of CAA from 25％ to 4％. Nitrogen-terminal B-type natriuretic peptide ( NT-proBNP ) , originally used for the management of adults with heart disease, was shown to be useful in the diagnosis and management of patients with KD. NT-proBNP is released by cardiomyocytes in response to mechanical factors, such as the dilation of cardiac chambers, and to pro-inflammatory cytokines. Patients with KD have higher NT-proBNP at the time of diagnosis than febrile controls. Moreover, patients with resistance to IVIG treatment and CAA were found to have higher levels of NT-proBNP, suggesting a prognostic role. This review summarizes the signifi-cance of NT-proBNP in the diagnostic value of KD in recent years.