Establishment of detection methods of myocardial ischemia in patients with Kawasaki disease using novel parameters of electrocardiography and magnetocardiography

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K19627
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Pediatrics
• Research Institution: National Cardiovascular Center Research Institute (2018); University of Tsukuba (2016-2017)
• Principal Investigator: Kato Yoshiaki 国立研究開発法人国立循環器病研究センター, 病院, 医師 (90635608)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 心磁図 / 川崎病 / 電流分布 / 心筋虚血 / 冠動脈病変 / 再分極異常

Outline of Final Research Achievements

We analyzed parameters of magnetocardiography (MCG) in 63 patients who had Kawasaki disease-induced coronary artery lesions confirmed by angiography. We calculated the repolarization abnormal score from MCG parameters based on current distributions of T wave. We divided subjects into two groups according to the presence of coronary stenotic lesions, and compared the scores. There was a significant difference in the repolarization abnormal score between two groups (p = 0.019). Score was higher in the group of coronary stenotic lesions (2.5 ± 1.68). The sensitivity of the score over “1” for coronary stenotic lesion was 88.9 %, and specificity and positive predictive value were 29.6 % and 62.7 % respectively. In this study, due to the low specificity, there was limitation in detection of coronary stenotic lesions using repolarization abnormal score alone. However, if combined with other modalities, MCG-based assessments might be useful in detection of myocardial ischemia.

Free Research Field

小児科学

Academic Significance and Societal Importance of the Research Achievements

川崎病の一部では冠動脈病変を来し、心筋虚血が問題となる。簡易かつ非侵襲的に心筋虚血を検出できる方法として心磁図の有用性を検討した。川崎病冠動脈病変の患者における再分極過程の異常を心磁図による電流分布から定量的な評価を行い、その特徴を検討した。心磁図を用いて早期に心筋虚血を検出し、治療介入を開始できれば、心血管イベントのリスクを軽減でき、川崎病患者の予後改善に貢献できる可能性がある。