Linda Spigelblatt

Publications (2)3.61 Total impact

• Article: Marked variations in serial coronary artery diameter measures in Kawasaki disease: a new indicator of coronary involvement.

  Frédéric Dallaire, Anne Fournier, Jolène Breton, Thanh-Diem Nguyen, Linda Spigelblatt, Nagib Dahdah
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  ABSTRACT: The long-term risk of patients with Kawasaki disease is not well defined. A great proportion of patients with Kawasaki disease have important variation of their coronary artery (CA) diameters, but the significance of this variation is not known. The aim of this study was to test the hypothesis that patients within the normal range of CA diameters but with important Z-score variation have a stronger inflammatory response and increased resistance to treatment than those without such Z-score variation. A retrospective study was conducted in 197 patients with Kawasaki disease with serial echocardiograms up to 12 months after diagnosis. Patients with occult CA dilatation (variation > 2 Z-score units but within the normal range) were compared with patients with definite CA dilatation (Z score > 2.5) and with patients with normal CA for resistance to treatment and systemic inflammatory parameters. A total of 63 patients (32.0%) were identified with Z scores always within the normal range but with important variation of CA diameter during follow-up (occult dilatation). There was a strong statistically significant trend of increasing inflammatory marker levels across patient categories (normal > occult dilatation > definite dilatation). Furthermore, resistance to intravenous immunoglobulin therapy was significantly increased in patients with occult dilatation compared with patients with normal CAs (relative risk, 2.6; 95% confidence interval, 1.21-5.44; P = .006). The suggested definition of occult CA dilatation identified patients with CA involvement currently unrecognized per the current guidelines. These patients might be at a higher CA risk than previously thought.
  Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography 08/2012; 25(8):859-65. · 2.98 Impact Factor
• Article: Value of amino-terminal pro B-natriuretic peptide in diagnosing Kawasaki disease.

  Ariane McNeal-Davidson, Anne Fournier, Linda Spigelblatt, Claire Saint-Cyr, Thomas S Mir, Amiram Nir, Frédéric Dallaire, Jocelyne Cousineau, Edgard Delvin, Nagib Dahdah
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  ABSTRACT: Background:  The aim of the present study was to investigate the diagnostic value of the N-terminal B-type natriuretic peptide (NT-proBNP) in acute Kawasaki disease (KD) given that the clinical criteria and the current basic laboratory tests lack the necessary specificity for accurate diagnosis. Methods:  Basic biological tests and serum NT-proBNP levels obtained from acute KD patients were compared to that of febrile controls. NT-proBNP was considered abnormal based on the following definitions: above a cut-off determined on receiver operator characteristic (ROC) analysis, above the upper limit for age, or above 2 SD calculated from healthy children. Analyses were also performed for KD cases with complete or incomplete criteria combined and separately. Results:  There were 81 patients and 49 controls aged 3.60 ± 2.77 versus 4.25 ± 3.88 years (P= 0.69). ROC analysis yielded significant area under the curve for NT-proBNP. The sensitivity, specificity, positive and negative predictive values were 70.4-88.9%, 69.4-91.8%, 82.8-93.4%, and 65.2-79.1%. The odds ratios based on NT-proBNP definitions varied between 18.13 (95% confidence interval [CI]: 7.21-45.57), 20.82 (95%CI: 8.18-53.0), and 26.71 (95%CI: 8.64-82.57; P < 0.001). Results were reproducible for cases with complete or incomplete criteria separately. Conclusion:  NT-proBNP is a reliable marker for the diagnosis of KD. Prospective clinical studies with emphasis on NT-proBNP in a diagnostic algorithm are needed.
  Pediatrics International 03/2012; 54(5):627-633. · 0.63 Impact Factor