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Atrioventricular depolarization differences identify coronary artery anomalies in Kawasaki disease

Daniel Cortez1,2,3, Nandita Sharma3, Pei-Ni Jone1,2

  • 1Children's Hospital Colorado, Aurora, CO, USA.

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|September 30, 2016
PubMed

Insights

Atrioventricular depolarization differences, measured by the spatial or 2D PR angle, can identify coronary artery anomalies (CAA) in children with Kawasaki disease (KD). This finding aids in diagnosing heart issues in KD patients.

Area of Science:

  • Pediatric Cardiology
  • Electrocardiography
  • Cardiac Imaging

Background:

  • Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
  • Electrocardiogram (ECG) changes, including depolarization alterations, are observed in KD patients with coronary artery anomalies (CAA).
  • Identifying non-invasive methods to detect CAA in KD is crucial for timely intervention.

Purpose of the Study:

  • To investigate if 12-lead ECG-derived atrioventricular depolarization differences can identify CAA in pediatric KD patients.
  • To assess the utility of the spatial PR angle and 2D PR angle in differentiating KD patients with and without CAA.

Main Methods:

  • A retrospective, blinded case-control study involving 101 KD patients.
  • Analysis of ECG parameters including deep Q waves, corrected QT-intervals (QTc), spatial QRS-T angles, RMS-T, spatial PR angle, and 2D PR angle.
  • Statistical comparisons were made between KD patients with and without CAA.

Main Results:

  • The spatial PR angle was significantly different between KD patients with CAA (59.7° ± 31.1°) and those without (41.6° ± 11.5°, p < .001).
  • A spatial PR angle cutoff of 56.9° showed high predictive values for CAA.
  • The 2D PR angle (below 7° or above 92°) also demonstrated significant discriminatory power for CAA detection.

Conclusions:

  • Atrioventricular depolarization differences, specifically measured by the spatial or 2D PR angle, effectively differentiate KD patients with CAA from those without.
  • These ECG-derived parameters offer a potential non-invasive tool for identifying CAA in Kawasaki disease.
Abstract

Keywords:
KawasakiPR anglecoronary artery anomaliesvectorcardiography

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