Key result
Intravenous immunoglobulin treatment in acute Kawasaki disease was associated with increased left ventricular stroke volume and MAPSE z-score, with BNP correlating with LVEF only prior to treatment.
Why the study?
Does intravenous immunoglobulin improve left ventricular function parameters in pediatric patients with acute Kawasaki disease?
Observational (n=28)
Does intravenous immunoglobulin improve left ventricular function parameters in pediatric patients with acute Kawasaki disease?
In acute Kawasaki disease, left ventricular stroke volume and longitudinal function are reduced before IVIG and improve after treatment, while BNP is only a reliable marker of LV function prior to IVIG.
Answers are grounded in this paper and cite their sources.
Supports serial LV monitoring in acute Kawasaki disease; leaves open whether IVIG drives recovery or if BNP utility is timing-specific.
BACKGROUND: The relationship between left ventricular (LV) function and longitudinal or radial contraction has not yet been elucidated in acute Kawasaki disease (KD), especially before and after treatment with intravenous immunoglobulin (IVIG). METHODS: We studied 28 KD patients without coronary aneurysms (average age, 3.2 years). The LV end-diastolic volume (LVEDV), end-systolic volume (LVESV), stroke volume (LVSV), and ejection fraction (LVEF) were assessed on 3-D echocardiography before IVIG, after IVIG, and in the convalescent phase. LV fractional shortening (LVFS) and the mitral annular plane systolic excursion (MAPSE) z-score were measured as surrogates for radial and longitudinal LV wall motions, respectively. Serum brain natriuretic peptide (BNP) was also assessed as a heart failure indicator in acute KD patients. RESULTS: In all KD patients, LVEDV decreased in the acute phase with preservation of LVESV. Both LVSV and MAPSE z-score were lowest before IVIG and increased after IVIG. MAPSE z-score was highly correlated with LVEF before and after IVIG treatment. Although there was a good correlation between logBNP and LVEF before IVIG, it was lost after IVIG. CONCLUSIONS: LVEDV decreased longitudinally during the acute phase of KD with preservation of LVESV, reducing both LVSV and LVEF. Serum BNP is a useful marker for evaluating LV function only prior to IVIG treatment.
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Hashimoto et al. (2017) conducted an observational in Acute Kawasaki disease (n=28). Intravenous immunoglobulin (IVIG) vs. Before IVIG treatment was evaluated on Left ventricular function parameters (LVEDV, LVESV, LVSV, LVEF) and MAPSE z-score. Intravenous immunoglobulin treatment in acute Kawasaki disease was associated with increased left ventricular stroke volume and MAPSE z-score, with BNP correlating with LVEF only prior to treatment.
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