Predictive value of heart rate deceleration capacity on coronary artery lesion in acute phase of Kawasaki disease

Yaheng Lu,Feifei Si,Yonghong Guo,Yizhou Wen,Mei Jin,Xianmin Wang,Tingting Chen

doi:10.1038/s41598-020-67121-3

Abstract

This study was to investigate the correlation of vagal activity with coronary artery lesion (CAL) in Kawasaki disease (KD) children, and assess the predictive value of heart rate deceleration capacity (DC) for CAL in acute phase of KD.50 KD children with CAL, 130 KD children without CAL, 30 children with acute upper respiratory infection and 100 healthy children were recruited and indicators reflecting vagal activity including DC were measstuogram. KD children with CAL showed decreased vagal activity with significantly lower values of DC. DC was negatively correlated with levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) in KD children. DC was a usable cardiac electrophysiological index to predict CAL in children with KD, with an area under the receiver operating characteristic curve (AUC) of 0.741. The cut-off value of DC for predicting CAL in KD children was 4.37 ms. DC was an independent predictor of CAL in children with KD, evaluated by multiple logistic regression analysis, KD children with DC ≤ 4.37 ms had an increased risk of CAL, with odds ratios (OR) of 5.94. Our study illustrates DC could be used to predict CAL in acute phase of KD.

Highlights

Kawasaki disease (KD) is an acute febrile systemic vasculitis syndrome, which is one of the most common acquired heart disease in children[1]
We observed that deceleration capacity (DC), PNN50 and high frequency (HF) in acute upper respiratory tract infection (AURI) children and KD children with or without coronary artery lesion (CAL) were significantly reduced compared with the healthy children, indicating that vagal activity was decreased in febrile children
We found DC, PNN50, RMSSD and HF were not significantly different between AURI children and KD children without CAL, indicating that there was no difference in vagal activity between children with different febrile illness

Summary

Introduction

Kawasaki disease (KD) is an acute febrile systemic vasculitis syndrome, which is one of the most common acquired heart disease in children[1]. Studies have shown that some biochemical indicators are associated with CAL in KD, but there are relatively few reliable indicators for predicting CAL in the acute phase of disease[5,6,7,8]. Since HRV method cannot accurately distinguish between the vagal and sympathetic activities of the autonomic nervous system, Heart rate deceleration capacity (DC) as a new indicator, which reflects the general trend of sinus rhythm RR interval and its ability to decelerate, has been discovered that can more accurately and quantitatively evaluate vagal activity and has a better warning ability of adverse cardiac events than HRV15–18. We aimed to investigate the correlation of vagal activity with CAL in KD children, and assess the predictive value of DC for CAL in acute phase of KD

Objectives

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Results

Conclusion