Inflammation aggravates heterogeneity of ventricular repolarization in children with Kawasaki disease

Area of Science:

• Pediatric Cardiology
• Electrophysiology
• Inflammatory Diseases

Background:

• Kawasaki disease frequently involves myocarditis and vasculitis.
• Ventricular repolarization abnormalities may occur even in asymptomatic myocarditis during the acute phase.
• Early identification of cardiac complications is crucial for Kawasaki disease management.

Purpose of the Study:

• To assess if changes in ventricular repolarization characteristics predict myocarditis and coronary artery lesions in Kawasaki disease.
• To evaluate the Tp-e/QT ratio as a potential predictor for coronary dilation.

Main Methods:

• Retrospective analysis of 34 children treated for Kawasaki disease with intravenous immunoglobulin.
• Measurement of QT interval and Tpeak-to-Tend (Tp-e) interval during acute and recovery phases.
• Correlation analysis of Tp-e/QT ratio with C-reactive protein (CRP) levels, body temperature, and coronary artery dilation.

Main Results:

• The Tp-e/QT ratio in the acute phase positively correlated with body temperature and CRP levels.
• Patients with transient coronary artery dilation exhibited significantly higher Tp-e/QT ratios compared to those without dilation.
• The Tp-e/QT ratio demonstrated a strong association with transient coronary dilation.

Conclusions:

• The Tp-e/QT ratio is a valuable indicator for predicting transient coronary dilation in Kawasaki disease.
• This electrophysiological marker shows a stronger relationship with coronary dilation than inflammatory markers like fever and CRP.
• The findings suggest Tp-e/QT can aid in identifying children at risk for coronary complications.