Prognostic Significance of QT Interval Dispersion in the Response to Intravenous Immunoglobulin Therapy in Kawasaki Disease.

Abstract

BACKGROUND:

Kawasaki disease (KD) is classified as a systemic vasculitis syndrome and QT interval dispersion (QTD) has been associated with cardiac involvement and disease activity in patients with cardiovasculitis. We examined whether baseline QTD could predict a response to intravenous immunoglobulin (IVIG) in KD.Methods and Results:QTD was recorded in 86 patients with KD before IVIG, who were separated into IVIG responders (R group; n=62) and nonresponders (N group; n=24). The association between baseline QTD and response to IVIG was investigated, and the predictive response value was compared with conventional risk scores from Gunma and Kurume universities. Baseline-corrected QTDs with Bazett's (QTbcD) and Fridericia's (QTfcD) formulae were significantly increased in the N group (R group vs. N group: 31.6 [28.3, 44.0] ms vs. 66.6 [50.5, 76.3] ms and 27.4 [25.2, 39.1] ms vs. 55.2 [42.4, 66.3] ms, respectively, both P<0.001). Multiple logistic regression analysis revealed QTfcD as an independent predictor of a response to IVIG after adjustment for conventional scores (odds ratio: 1.133, 95% confidence interval: 1.061-1.210, P<0.001). Moreover, QTfcD provided incremental predictive value for IVIG nonresponders over Gunma score (increment in global χ2=25.46, P<0.001).

CONCLUSIONS:

QTD was significantly associated with a response to IVIG in KD patients and may represent a useful identifier of IVIG nonresponders with high risk of coronary aneurysm.

• Authors: Noriko Motoki, Yohei Akazawa, Shoko Yamazaki, Akira Hachiya, Hirohiko Motoki, Satoshi Matsuzaki, Kenichi Koike
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 81 Issue 4 Pg. 537-542 (Mar 24 2017) ISSN: 1347-4820 [Electronic] Japan
• PMID: 28154289 (Publication Type: Journal Article)

Chemical References

• Immunoglobulins, Intravenous

Topics

• Child, Preschool
• Coronary Aneurysm
• Electrocardiography (methods)
• Female
• Humans
• Immunoglobulins, Intravenous (pharmacology, therapeutic use)
• Infant
• Male
• Mucocutaneous Lymph Node Syndrome (diagnosis, drug therapy, physiopathology)
• Predictive Value of Tests
• Prognosis
• Retrospective Studies
• Risk Assessment