Daniel Cortez
Children’s Hospital Colorado, USA
Title: Quantitative repolarization differences predict Kawasaki disease while atrio-ventricular depolarization differences predict coronary artery anomalies
Biography
Biography: Daniel Cortez
Abstract
Introduction: Kawasaki disease (KD) is the leading cause of acquired heart disease in children. 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 most accurate 12-lead ECG and VCG 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-/gender-matched controls was performed. Deep Qwaves, corrected QT-intervals (QTc), spatial QRS-T angles, principle T-wave component vector (RMS-T) and spatial P-R angles (SPR angles) were assessed. Student t-tests, Chi square, and Analysis of Variance were used to identify significant differences between groups.
Results: Fifty patients with KD (mean age 3.1 ± 3.1 years, 26% female) were compared to fifty control patients (mean age 3.8 ± 2.9 years, 44% female). Of the KD patients, 32 (64%) were diagnosed as atypical KD and 28 (56%) of them had CAA. KD patients were significantly differentiated from control patients by deep Qwaves (72% versus 44% p= 0.005), QTc values (395.1 ± 24.7 ms versus 410.4 ± 34.7ms, p= 0.013), and the RMS-T (4.2 ± 0.2dmV versus 6.3 ± 0.3dmV p= <0.001), respectively. Atypical KD was also discriminated from controls with an odds ratio or 22.3. The spatial P-R angle significantly discriminated CAA from those without.
Conclusion: The RMS-T differentiates KD, typical or atypical from controls. Kawasaki patients with coronary artery anomalies were differentiated from those without coronary changes by the SPR angle.