Abstract 17150: Prognostic Significance of QT Interval Dispersion in the Response to Intravenous Immunoglobulin Therapy in Kawasaki Disease
Introduction: Increased QT interval dispersion (QTD) has been shown to reflect cardiac instability in several cardiovascular diseases. QTD has been associated with cardiac involvement and disease activity in patients with cardiovasculitis, such as SLE.
Hypothesis: We hypothesize that QTD could assess disease severity in Kawasaki disease (KD).
Methods: QTD was recorded in 86 patients with KD before intravenous immunoglobulin (IVIG) therapy, who were separated into IVIG responders (R group; n=62; median age: 2.0 ± 1.8 years) and non-responders (N group; n=24; median age: 3.2 ± 1.9 years). The association between baseline QTD and response to IVIG was investigated, and the predictive response value was compared with established risk scores from Gunma and Kurume universities.
Results: Baseline QTD and corrected QTD with Bazzet’s (QTbcD) and Fridericia’s formulae (QTfcD) were significantly increased in the N group (R group vs. N group: 20.0 ± 23.1 ms vs. 41.3 ± 13.0 ms, 31.6 ± 35.2 ms vs. 64.3 ± 18.9 ms and 27.4 ± 30.8 ms vs. 55.5 ± 16.6 ms, respectively, both P< 0.001). According to receiver-operating characteristic curve analysis, the area under the curve of QTfcD (0.89) was comparative with those of conventional scores. 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% CI: 1.061-1.210, P<0.001).
Conclusion: QTD was significantly associated with a response to IVIG in KD and may represent a useful identifier of IVIG non-responders with severe vasculitis and high risk of coronary aneurysm.
Author Disclosures: N. Motoki: None. Y. Akazawa: None. S. Yamazaki: None. A. Hachiya: None. H. Motoki: None. S. Matsuzaki: None. K. Koike: None.
- © 2016 by American Heart Association, Inc.