Association Between the Persistency and Severity of Mitral Regurgitation and the Hematologic Z-Values of Inflammatory Biomarkers in Kawasaki Disease
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND OBJECTIVES: Valvulitis is frequently found in Kawasaki disease (KD). However, the persistence and severity of mitral regurgitation (MR) in KD are not well-known. This study examined the correlation between MR and z-values of inflammatory serum biomarkers. METHODS: Patients with KD at Korea University Hospital over 15-year period were retrospectively investigated. Echocardiography and inflammatory serum biomarkers were examined in 371 patients with KD (241 with MR and 130 without) and 144 patients with febrile illness (control). Serum biomarkers (raw and z-values) were compared among the positive, negative, all, and no MR groups during each phase of KD. RESULTS: Neutrophil, z-neutrophil, lymphocyte, z-lymphocyte, neutrophil-lymphocyte ratio, hemoglobin, z-hemoglobin, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) all differed significantly between the positive and negative MR groups and between the all and no MR groups during the acute phase (p<0.05). A part of white blood cell (WBC), z-WBC, neutrophil, z-neutrophil, neutrophil to lymphocyte ratio, hemoglobin, z-hemoglobin, CRP, ESR, aspartate transaminase, and sodium were associated with severity of MR through correlation analysis and multivariate logistic regression (p<0.05). Optimal cut-off values of neutrophils, z-neutrophils, CRP, and ESR to predict persistent MR were 8,100 /μL, 2.2, 61 mg/dL, and 77 mm/h. CONCLUSIONS: A comparison of hematological z-values in KD with MR and in KD without MR is useful for predicting more severe inflammation. Neutrophils, z-neutrophils, and ESR were significant and consistently associated with pathogenesis of MR and their levels during the early inflammation can predict the persistency and severity of MR.
Source: Korean Circulation Journal
Authors: Jue Seong Lee, Suk Young Lee, Junghwa Lee, Gi Young Jang, Woo Young Kim, Kee Soo Ha
Institution: Korea University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7109994429