{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:56:41Z","timestamp":1787068601613,"version":"build-2736575974"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,1,7]]},"abstract":"\n Background<\/jats:title>\n \n Coronary artery aneurysms and myocarditis are well\u2010recognized complications of Kawasaki disease (\n KD<\/jats:styled-content>\n ) but no systematic evaluation of the consequences of myocarditis has been performed in the subset presenting with low ejection fraction (\n EF<\/jats:styled-content>\n ). We postulated that more severe myocardial inflammation as evidenced by low\n EF<\/jats:styled-content>\n during the acute phase could lead to late myocardial fibrosis.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We measured the carboxyterminal propeptide of procollagen type I (\n PIPC<\/jats:styled-content>\n ), soluble suppressor of tumorigenicity 2, galectin\u20103 (Gal\u20103), growth\u2010differentiation factor\u201015, and calprotectin by\n ELISA<\/jats:styled-content>\n in late convalescent blood samples from 16\n KD<\/jats:styled-content>\n patients who had an\n EF<\/jats:styled-content>\n \u226455% on their initial echocardiogram. Results were compared with samples from sex\u2010 and age\u2010matched\n KD<\/jats:styled-content>\n patients with initial\n EF<\/jats:styled-content>\n >60%. In the univariate analysis, the median Gal\u20103 and\n PIPC<\/jats:styled-content>\n levels in the low\n EF<\/jats:styled-content>\n group were significantly higher than those in the normal\n EF<\/jats:styled-content>\n group (Gal\u20103: low\n EF<\/jats:styled-content>\n 6.216 versus normal\n EF<\/jats:styled-content>\n 4.976\u00a0mg\/dL\n P<\/jats:italic>\n =0.038,\n PIPC<\/jats:styled-content>\n : low\n EF<\/jats:styled-content>\n 427.4 versus normal\n EF<\/jats:styled-content>\n 265.2\u00a0mg\/dL,\n P<\/jats:italic>\n =0.01). In a multivariable analysis, there were significant differences for Gal\u20103 and\n PIPC<\/jats:styled-content>\n levels between the low and normal\n EF<\/jats:styled-content>\n groups, adjusting for age, sex, and worst z score.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Convalescent\n KD<\/jats:styled-content>\n patients with a history of low\n EF<\/jats:styled-content>\n during the acute illness had significantly elevated levels of Gal\u20103 and\n PIPC<\/jats:styled-content>\n when compared with matched\u2010control\n KD<\/jats:styled-content>\n patients with normal\n EF<\/jats:styled-content>\n . These findings raise concern for myocardial fibrosis as a potential late sequela of the more severe myocarditis experienced by a subset of\n KD<\/jats:styled-content>\n patients during the acute phase.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.014569","type":"journal-article","created":{"date-parts":[[2019,12,27]],"date-time":"2019-12-27T17:00:22Z","timestamp":1577466022000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Biomarkers of Inflammation and Fibrosis in Kawasaki Disease Patients Years After Initial Presentation With Low Ejection Fraction"],"prefix":"10.1161","volume":"9","author":[{"given":"Shinsuke","family":"Hoshino","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of California San Diego School of Medicine La Jolla CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chisato","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California San Diego School of Medicine La Jolla CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Public Health University of California San Diego La Jolla CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"He","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Public Health University of California San Diego La Jolla CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana H.","family":"Tremoulet","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California San Diego School of Medicine La Jolla CA"},{"name":"Rady Children's Hospital San Diego San Diego CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane C.","family":"Burns","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California San Diego School of Medicine La Jolla CA"},{"name":"Rady Children's Hospital San Diego San Diego CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.12.073"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000484"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.12.011"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003072-199208000-00002"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.58.4.385"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(81)90404-5"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(00)90229-1"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(85)90523-X"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-1871"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-1275"},{"key":"e_1_3_1_12_2","first-page":"470","article-title":"Cardiac biopsy of Kawasaki disease","volume":"105","author":"Yutani C","year":"1981","unstructured":"Yutani C, Go S, Kamiya T, Hirose O, Misawa H, Maeda H, Kozuka T, Onishi S. 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