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Repolarization Vector Magnitude Differentiates Kawasaki Disease from Normal Children

Cortez, Daniel LU ; Patel, Sonali; Sharma, Nandita; Landeck, Bruce F; McCanta, Anthony C. and Jone, Pei-Ni (2016) In Annals of Noninvasive Electrocardiology 21(5). p.9-493
Abstract

INTRODUCTION: Kawasaki disease (KD) is the leading cause of acquired heart disease in children. The 12-lead electrocardiogram (ECG) changes in patients during the acute phase of KD include flattened T waves and prolonged corrected QT intervals (QTc). We set out to determine the 12-lead ECG and vectorcardiography predictors for identification of patients with KD and which of these predictors would be clinically useful for early identification of those with coronary artery anomalies (CAA).

METHODS: A blinded, retrospective case-control study of patients with KD and age-matched controls was performed. Deep Q waves, QTc, spatial QRS-T angles, and T-wave vector magnitude (root mean square of the T wave, RMS-T) were assessed.... (More)

INTRODUCTION: Kawasaki disease (KD) is the leading cause of acquired heart disease in children. The 12-lead electrocardiogram (ECG) changes in patients during the acute phase of KD include flattened T waves and prolonged corrected QT intervals (QTc). We set out to determine the 12-lead ECG and vectorcardiography predictors for identification of patients with KD and which of these predictors would be clinically useful for early identification of those with coronary artery anomalies (CAA).

METHODS: A blinded, retrospective case-control study of patients with KD and age-matched controls was performed. Deep Q waves, QTc, spatial QRS-T angles, and T-wave vector magnitude (root mean square of the T wave, RMS-T) were assessed. Comparisons between groups were performed to test for significant differences.

RESULTS: Fifty patients with KD (mean age 3.1 ± 3.1 years, 26% female) were compared to 50 previously healthy control patients (mean age 3.8 ± 2.9 years, 44% female). Of the KD patients, 32 (64%) were diagnosed as incomplete KD and 28 (56%) of them had CAA. When compared to the control group, KD patients had abnormal Q waves (72% vs 44% P = 0.005), shorter QTc values (395.1 ± 24.7 ms vs 410.4 ± 34.7 ms, P = 0.013), and lower RMS-T (0.42 ± 0.02 mV vs 0.63 ± 0.03 mV P < 0.001), respectively. Incomplete KD was also discriminated from controls by the same parameters. No differences were noted between KD patients with versus without CAA.

CONCLUSION: The RMS-T differentiates complete and incomplete KD from controls. KD patients with CAA were not differentiated from those without CAA.

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author
publishing date
type
Contribution to journal
publication status
published
keywords
Case-Control Studies, Child, Preschool, Coronary Artery Disease, Electrocardiography, Female, Humans, Male, Mucocutaneous Lymph Node Syndrome, Predictive Value of Tests, Retrospective Studies, Vectorcardiography, Journal Article
in
Annals of Noninvasive Electrocardiology
volume
21
issue
5
pages
7 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:84985918778
ISSN
1082-720X
DOI
10.1111/anec.12338
language
English
LU publication?
no
id
106ed026-cc37-4cce-80ec-679747a0c315
date added to LUP
2017-08-29 08:22:07
date last changed
2017-09-03 05:26:27
@article{106ed026-cc37-4cce-80ec-679747a0c315,
  abstract     = {<p>INTRODUCTION: Kawasaki disease (KD) is the leading cause of acquired heart disease in children. The 12-lead electrocardiogram (ECG) changes in patients during the acute phase of KD include flattened T waves and prolonged corrected QT intervals (QTc). We set out to determine the 12-lead ECG and vectorcardiography predictors for identification of patients with KD and which of these predictors would be clinically useful for early identification of those with coronary artery anomalies (CAA).</p><p>METHODS: A blinded, retrospective case-control study of patients with KD and age-matched controls was performed. Deep Q waves, QTc, spatial QRS-T angles, and T-wave vector magnitude (root mean square of the T wave, RMS-T) were assessed. Comparisons between groups were performed to test for significant differences.</p><p>RESULTS: Fifty patients with KD (mean age 3.1 ± 3.1 years, 26% female) were compared to 50 previously healthy control patients (mean age 3.8 ± 2.9 years, 44% female). Of the KD patients, 32 (64%) were diagnosed as incomplete KD and 28 (56%) of them had CAA. When compared to the control group, KD patients had abnormal Q waves (72% vs 44% P = 0.005), shorter QTc values (395.1 ± 24.7 ms vs 410.4 ± 34.7 ms, P = 0.013), and lower RMS-T (0.42 ± 0.02 mV vs 0.63 ± 0.03 mV P &lt; 0.001), respectively. Incomplete KD was also discriminated from controls by the same parameters. No differences were noted between KD patients with versus without CAA.</p><p>CONCLUSION: The RMS-T differentiates complete and incomplete KD from controls. KD patients with CAA were not differentiated from those without CAA.</p>},
  author       = {Cortez, Daniel and Patel, Sonali and Sharma, Nandita and Landeck, Bruce F and McCanta, Anthony C. and Jone, Pei-Ni},
  issn         = {1082-720X},
  keyword      = {Case-Control Studies,Child, Preschool,Coronary Artery Disease,Electrocardiography,Female,Humans,Male,Mucocutaneous Lymph Node Syndrome,Predictive Value of Tests,Retrospective Studies,Vectorcardiography,Journal Article},
  language     = {eng},
  number       = {5},
  pages        = {9--493},
  publisher    = {Wiley-Blackwell},
  series       = {Annals of Noninvasive Electrocardiology},
  title        = {Repolarization Vector Magnitude Differentiates Kawasaki Disease from Normal Children},
  url          = {http://dx.doi.org/10.1111/anec.12338},
  volume       = {21},
  year         = {2016},
}