Gravel Hugo, Dahdah Nagib, Fournier Anne, Mathieu Marie-Ève, Curnier Daniel
Division of Pediatric Cardiology, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada.
Pediatr Cardiol. 2012 Jun;33(5):728-34. doi: 10.1007/s00246-012-0201-3. Epub 2012 Feb 18.
Exercise testing can highlight repolarisation abnormalities in adults with coronary artery disease. Late after Kawasaki disease (KD), increased QT dispersion (QTd) has been reported on resting ECG in children, but there are no reported studies of QTd during exercise. Our objective was to determine the pattern of QTd response to exercise testing in children late after KD. Twenty-five KD patients without coronary complications, 28 with coronary dilation, and 18 with severe complications were compared with 28 controls. KD patients were 11.6 ± 3.0 years old versus 12.8 ± 2.9 for controls [p = not significant (NS)], and these patients were studied 7.5 ± 3.4 years after the onset of the disease. QT was measured from the onset of QRS to the apex (QTa) and the end (QTe) of T wave. Resting QTd was significantly increased in KD subjects (p < 0.05). The proportion of abnormal QTd was evenly distributed across the three KD groups (29-36%; p = NS). QTd response to exercise was significantly altered in KD, irrespective of resting QTd or coronary sequelae. Abnormal resting- and exercise-induced repolarisation are detectible after KD irrespective of the severity of coronary sequelae.
运动试验可凸显成年冠心病患者的复极异常。据报道,川崎病(KD)患儿静息心电图的QT离散度(QTd)在疾病后期会增加,但尚无关于运动期间QTd的研究报道。我们的目的是确定KD患儿运动试验后QTd的反应模式。将25例无冠状动脉并发症的KD患者、28例有冠状动脉扩张的患者和18例有严重并发症的患者与28例对照者进行比较。KD患者的年龄为11.6±3.0岁,对照者为12.8±2.9岁[P =无显著性差异(NS)],这些患者在疾病发作后7.5±3.4年接受研究。QT从QRS波起点测量至T波顶点(QTa)和终点(QTe)。KD患者静息QTd显著增加(P<0.05)。异常QTd的比例在三个KD组中分布均匀(29%-36%;P = NS)。KD患者运动后QTd反应显著改变,与静息QTd或冠状动脉后遗症无关。KD后无论冠状动脉后遗症的严重程度如何,均可检测到静息和运动诱发的异常复极。