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Tachycardia as a potential risk indicator for coronary arterial lesions in Kawasaki disease
Insights
Marked tachycardia in Kawasaki Disease (KD) patients, identified via 24-hour ambulatory ECG monitoring, is linked to developing coronary arterial lesions (CAL). This finding highlights tachycardia as a potential indicator for CAL risk in acute KD.
Area of Science:
- Pediatrics
- Cardiology
- Medical Diagnostics
Background:
- Tachycardia is common in acute Kawasaki Disease (KD).
- The relationship between acute-phase tachycardia and coronary arterial lesions (CAL) in KD remains unclear.
- Investigating predictors for CAL is crucial for early intervention in KD.
Purpose of the Study:
- To assess the association between mean 24-hour heart rate during the acute phase of KD and the development of CAL.
- To determine if 24-hour ambulatory ECG monitoring can identify KD patients at higher risk for CAL.
Main Methods:
- A cohort of 26 KD patients underwent 24-hour ambulatory ECG monitoring during the febrile phase, before day 9 of illness.
- Mean 24-hour heart rate was compared between patients who developed CAL and those who did not.
- Multiple regression analysis was used to identify significant correlations.
Main Results:
- Seven out of 26 patients developed CAL.
- Patients with CAL exhibited a significantly higher mean 24-hour heart rate (144 ± 14 bpm) compared to those without CAL (124 ± 22 bpm).
- Mean 24-hour heart rate was significantly correlated with CAL development (P=0.019).
Conclusions:
- Elevated heart rate detected by 24-hour ambulatory ECG in acute KD may predict CAL development.
- This monitoring method could offer valuable insights into CAL risk stratification in KD patients.
- Further research is warranted to confirm these findings and explore clinical implications.
Unlabelled:
Tachycardia is frequently observed in the acute phase of Kawasaki Disease (KD) patients. However, little is known about the association between the tachycardia in the acute phase of KD and the development of coronary arterial lesions (CAL). We examined the association between the mean 24 h heart rate in the acute phase of KD observed using 24 h ambulatory ECG monitoring (24 h-ECG) and the occurrence of CAL in patients. In a study conducted between 1994 and 1997, 26 patients with KD underwent 24 h-ECG within the febrile period and before the 9th day of illness. We compared the mean 24 h heart rate based on 24 h-ECG between patients with and those without CAL. Of 26 patients, 7 had CAL. The groups with and without CAL had similar baseline characteristics. The mean 24 h heart rate in the group with CAL was significantly higher than that in the group without CAL (144 +/- 14 vs. 124 +/- 22, P = 0.033). On multiple regression analysis, the mean 24 h heart rate was significantly correlated with the development of CAL (P = 0.019).
Conclusion:
Marked tachycardia detected by 24 h-ambulatory ECG monitoring in the acute phase of Kawasaki disease might provide important information on the development of coronary arterial lesions.