Ask the KD Experts: Biomarkers of Inflammation and Fibrosis in KD Patients

Ask the KD Experts: Biomarkers of Inflammation and Fibrosis in Kawasaki Disease Patients Years After Initial Presentation With Low Ejection Fraction

Question:

Can you please explain the results of a recent study published titled “Biomarkers of Inflammation and Fibrosis in Kawasaki Disease Patients Years After Initial Presentation With Low Ejection Fraction”?

Answer:

The study results apply to all patients with acute KD who have inflammation in the heart muscle as well as in the arteries. Sometimes, the inflammation is so severe that it reduces the squeeze of the heart muscle. Fortunately, this problem is quickly reversed in most patients by IVIG treatment.

The researchers at the KD Research Center at UCSD asked whether these children who presented with a reduced squeeze of the heart muscle during their acute KD might later develop evidence of scarring in the heart muscle. To study this, the team collected blood samples many years after recovery from KD patients who did or did not have reduced heart muscle function. In the blood, they measured proteins that are frequently used by adult cardiologists to monitor scarring in the heart muscle in adults with heart failure. This was the first time these protein measurements had been applied to the study of children.

The researchers found that indeed there was suggestive evidence of scarring with elevated levels of these proteins (called biomarkers) in children and teenagers with a history of reduced heart muscle function. These findings suggest that this subset of children with KD should be followed with longitudinal testing of heart function even in the absence of coronary artery damage. This is a departure from the recommendations in the AHA guidelines.

Click here to read the full study.

Sincerely,

Jane C. Burns, M.D.
Professor and Director, Kawasaki Disease Research Center
Dept. of Pediatrics MC 0641
UCSD School of Medicine
9500 Gilman Dr.
La Jolla, CA 92093-0641