Abstract
[Aims] To investigate electrical disturbance in coronary artery stenosis due to Kawasaki disease using body surface mapping and QT dispersion. [Methods] Fifteen patients (ten males) with severe coronary artery stenosis due to Kawasaki disease underwent co ronary artery bypass graft at two to 16 years old (median 9). Using VCM3000TM (Fukuda, Japan), 87-leads ECG were recorded at rest and after injection of 0.6 mg/kg dipyridamole. Subtraction from after injection in each potentials 60 ms from J point and in tegrated QRST were defined as ST60 (mV) and sub-QRST-I-map (microVsec). Subtraction from normal control in each potential 20 and 30 ms from QRS, and integrated QRST, QRS and ST were defined as QRS20, QRS30, dep-QRST-I-map, dep-QRS-I-map and dep-ST-T-I-ma p. Leads under -2SD from control were counted as Da. Minimum potential in subtraction and Da were compared between before and late after the surgery. QT dispersion were calculated as the maximum minus the minimum QT interval of all leads in 87-lead ECG. W e investigated relationship between QT dispersion and Da. [Results] ST 60 and sub-QRST I map increased from -0.27+/-0.22 and -63.8+/-42.8 to -0.09+/-0.068 and -35.9+/-30.9, respectively (p<0.01). Da in QRS30, dep-QRST I map and dep-ST-T I map had significant change from 16.2+/-13.0, 5.2+/-12.5, 4.1+/-11.3 to 6.0+/-5.6, 13.2+/-9.6, 14.5+/-11.7, respectively (p<0.05). Additionally QT dispersion and Da in dep-QRST-I-map, dep-ST-T Imap had correlation each other (p<0.05). [Conclusion] Increment of ST60 and sub-QRST-I-map demonstrates improved ischemia. Decrement of Da in QRS30 supposes normalized myocardial potential. Although in dep-QRST-I-map and dep-ST-T-I-map increment of Da implicated abnormal ST segment. Additionally, correlation between Da in those and QTD assure the abnormal repolarization in severe coronary artery stenosis due to Kawasaki disease even after surgery. Whether such an abnormal repolarization results to arrhythmogenecity will be further investigated.
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Takamuro, M., Shimizu, T., Tsuda, E. et al. Body Surface Mapping Can Detects Abnormal Repolarization in Severe Coronary Artery Stenosis Due to Kawasaki Disease. Pediatr Res 53, 183 (2003). https://doi.org/10.1203/00006450-200301000-00175
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DOI: https://doi.org/10.1203/00006450-200301000-00175