The Significance Of Changed Serum N-terminal Pro-brain Natriuretic Peptide In Children With Kawasaki Disease Coronary Aneurysm And Other Complications

Purpose: To explore the significance of changed N-terminal pro-brain natriuretic peptide(NT-pro BNP)in children with Kawasaki disease(KD)coronary aneurysm(CAA)and other complications.Patients and Methods:Total 546 KD/IKD patients diagnosed and treated in Pediatric Cardiovascular Department,Shengjing hospital of China Medical University from Jan2021-June 2022 were retrospectively analyzed.They were divided to KD,incomplete KD(IKD),and IVIG-resistant KD/IKD(IVIG-R-KD/IKD)groups base on diagnosis.Furthermore,they were also divided into experimental group and control group according to whether there was myocardial injury,coronary aneurysm,and electroencephalogram(EEG)abnormality.The data including serum levels of NT-pro BNP,medical history prior to admission,white blood cell(WBC),Neutrophil(NE),C-reactive protein(CRP),procalcitonin(PCT),interleukin 6(IL6),albumin(ALB),alanine aminotransferase(ALT)and troponin I(c Tn I),images of coronary artery,and electroencephalograph(EEG)were collected.Results:The mean value of serum NT-pro BNP was 4410.96 ± 7002.87pg/m L in patients with myocardial damage,which was significantly higher than 745.91 ±1547.2pg/m L in patients without myocardial damage(P<0.01).The mean value of serum NT-pro BNP in patients with coronary aneurysm was 1650.99 ± 3623.93pg/m L,which was higher than 936.94 ± 2502.76pg/m L in patients without coronary aneurysm(P<0.05).A total of 355(65.02%)children improved their EEG,and 124/355(34.93%)children found abnormal slow waves,accounting for 22.34% of all cases.Surprisingly,the mean serum NT-pro BNP of children with abnormal EEG was 997.58 ±1818.85pg/m L,lower than 1699 ± 3956.23pg/m L of children with normal EEG(P<0.05),and the mean serum NT-pro BNP of children with mild abnormal EEG was 864.28 ±1729.13pg/m L,significantly lower than that of children with normal EEG(P<0.01).Classified by NT-pro BNP level,the proportion of abnormal EEG did not increased with the increase of NT-pro BNP level.The average NT-pro BNP of children in the IKD group was 570.02 ± 1171.02pg/m L,significantly lower than 1138.23 ±2657.27pg/m L in the KD group(P<0.01).In IVIG-R-KD/IKD group,the incidence of medium and giant CAA was higher than that in IKD group(P < 0.01),while the incidence of giant CAA was also higher than that in KD group(P < 0.01).NT-pro BNP was positively correlated with c Tn I,WBC,NE,CRP,IL6,PCT,ALT,r=0.48,0.16,0.14,0.36,0.52,0.20,0.12(P < 0.01).NT-pro BNP was negatively correlated with ALB,r=-0.23,P<0.01.Conclusion:The elevated serum NT-pro BNP in children with Kawasaki disease is associated with enhanced inflammatory response,myocardial damage,and coronary aneurysm,not of EEG abnormalities.The correlation of serum NT-pro BNP with EEG should be further investigated.