Abstract 80: Correlation of N-terminal pro-BNP Release with Myocardial Involvement in Acute Kawasaki Disease
Bibliographic record
Abstract
N-terminal pro-BNP (NT-proBNP) is elevated at the onset of Kawasaki Disease (KD). This is based on the hypothesis of immune myocardial inflammation. We sought to study the relationship between NT-proBNP and cardiac function in KD. Parameters of myocardial involvement determined by ECG (PR and QTc intervals, QT dispersion, R-T axis) and by echocardiogram (systole and diastole) were correlated with levels of NT-proBNP in the acute (1 week), sub-acute (2-3 months) and chronic (6 months to 1 year) phases of KD. KD patients were compared to a febrile group. KD patients were further subdivided into 2 groups according to the levels of NT-proBNP; normal NT-proBNP (NT-proBNP Z-score < 2), or elevated NT-proBNP (Z-score ≥ 2). There were 56 subjects (14 controls, 19 KD-1 and 23 KD-2 patients), with similar age at assessment (3.8±4.3 vs. 3.3±2.3 years-old, p=0.609). Myocardial contractility was significantly lower in KD patients in the acute phase with an ejection fraction of 57.4±7.5% compared to CTL 61.9±6.5%; p=0.049). Myocardial dysfunction was more significant in KD with high NT-proBNP compared to those with normal NT-proBNP, (shortening fraction Z-score of-1.6±1.5 versus -0.5±1.5; p=0.025) QTc interval was longer in KD compared to febrile CTL (412.3±21.0 mS vs. 390.6±14.6 mS, respectively; p=0.009). In contrast, there were no significant differences for left ventricular mass index (p=0.935) or LV end-diastolic diameter (p=0.565). Likewise, there were no significant differences for the PR interval (p=0.344), QT dispersion (p=0.288) or R-T axis (p=0.577). Otherwise, there was a significant correlation between coronary artery involvement (CA z-score ≥ 2.5) and the likelihood of lower LV ejection fraction (p=0.049) and higher NT-proBNP z-score (p=0.043), but no correlation with normalized LV shortening fraction (p=0.16) or QTc (p=0.14). The anomalous findings disappear in the sub-acute phase. On the other hand, a lengthening of QTc interval in the acute phase, irrespective of NT-proBNP status, resolves after 2-3 months. In acute KD, there is a reduction in myocardial function, to a higher extent in cases with elevated NT-proBNP. This correlates with coronary artery involvement. KD patients with elevated NT-proBNP z-score may warrant careful follow-up.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".