Related Experiment Video
Updated: Mar 27, 2026
Dual-Dye Optical Mapping of Hearts from RyR2R2474S Knock-In Mice of Catecholaminergic Polymorphic Ventricular Tachycardia
Published on: December 22, 2023
Repolarization Vector Magnitude Differentiates Kawasaki Disease from Normal Children
Daniel Cortez1,2, Sonali S Patel1,2, Nandita Sharma3
1Children's Hospital Colorado, Aurora, CO.
Insights
Electrocardiogram (ECG) changes, specifically T-wave vector magnitude (RMS-T), help identify children with Kawasaki disease (KD). However, these ECG findings do not predict coronary artery anomalies in KD patients.
Area of Science:
- Pediatric Cardiology
- Diagnostic Electrocardiography
Background:
- Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
- ECG changes in acute KD include flattened T waves and prolonged corrected QT intervals (QTc).
Purpose of the Study:
- To identify 12-lead ECG and vectorcardiography predictors for KD diagnosis.
- To determine if these predictors can identify KD patients with coronary artery anomalies (CAA).
Main Methods:
- Retrospective case-control study comparing KD patients and age-matched controls.
- Assessed deep Q waves, QTc, spatial QRS-T angles, and T-wave vector magnitude (RMS-T).
Main Results:
- KD patients showed abnormal Q waves, shorter QTc, and significantly lower RMS-T compared to controls.
- RMS-T differentiated both complete and incomplete KD from controls.
- No significant ECG differences were found between KD patients with and without CAA.
Conclusions:
- RMS-T is a valuable parameter for differentiating KD from controls.
- Current ECG and vectorcardiography methods do not predict CAA in KD patients.
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.
Related Concept Videos
01:30Cardiac Action Potential
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
01:19Electrophysiology of Normal Cardiac Rhythm