Risk factors of non-sustained ventricular tachycardia by technetium-perfusion imaging in patients with coronary artery lesions caused by Kawasaki disease.
Adolescent
Adult
Child
Child, Preschool
Coronary Artery Disease
/ diagnostic imaging
Female
Humans
Male
Middle Aged
Mucocutaneous Lymph Node Syndrome
/ diagnostic imaging
Myocardial Perfusion Imaging
Risk Factors
Tachycardia, Ventricular
/ diagnostic imaging
Technetium Tc 99m Sestamibi
Tomography, Emission-Computed, Single-Photon
Ventricular Function, Left
Young Adult
Coronary artery lesion
Extent score
Kawasaki disease
Myocardial perfusion imaging
Non-sustained ventricular tachycardia
Journal
Journal of cardiology
ISSN: 1876-4738
Titre abrégé: J Cardiol
Pays: Netherlands
ID NLM: 8804703
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
16
04
2018
revised:
26
08
2018
accepted:
28
10
2018
pubmed:
5
1
2019
medline:
7
5
2020
entrez:
5
1
2019
Statut:
ppublish
Résumé
Sudden death can occur in some patients with non-sustained ventricular tachycardia (NSVT) after myocardial infarction (MI) in those with coronary artery lesions (CAL) caused by Kawasaki disease (KD). The aim of this study was to determine the risk factors for NSVT in the late period after KD by technetium-99m-tetrofosmin myocardial perfusion imaging (MPI). We retrospectively analyzed the relation between the appearance of NSVT and the findings in MPI single-photon-emission computed tomography (SPECT) in 75 patients (55 males and 20 females) who had had CAL caused by KD. All the patients had undergone MPI and 24-h Holter electrocardiogram at the same time between 2003 and 2012. The age at MPI ranged from 2 to 44 years (median 19 years), and the time from the onset of KD to MPI ranged from 1 to 44 years (median 18 years). We evaluated extent score (ES), summed rest score (SRS), summed stress score (SSS), summed difference score (SDS), and left ventricular ejection fraction (LVEF) by quantitative gated SPECT software. We analyzed which factors related to NSVT using multivariate logistic regression. Further, we calculated the cut-off point for NSVT using receiver operating characteristic curve. The affecting factors were ES (OR, 0.63, 95%CI, 0.35-0.92, p=0.013) and the interval from the onset of KD to MPI (OR, 0.82, 95%CI, 0.69-0.96, p=0.004). The cut-off points for ES and the interval from the onset of KD were 11% (AUC, 0.931, p<0.001) and 18 years (AUC, 0.732, p=0.007), respectively. ES is the strongest parameter for predicting NSVT in the late period. In patients with post-KD, adolescence and young adults with ES ≥11% are at risk of fatal ventricular arrhythmia.
Sections du résumé
BACKGROUND
Sudden death can occur in some patients with non-sustained ventricular tachycardia (NSVT) after myocardial infarction (MI) in those with coronary artery lesions (CAL) caused by Kawasaki disease (KD). The aim of this study was to determine the risk factors for NSVT in the late period after KD by technetium-99m-tetrofosmin myocardial perfusion imaging (MPI).
METHODS
We retrospectively analyzed the relation between the appearance of NSVT and the findings in MPI single-photon-emission computed tomography (SPECT) in 75 patients (55 males and 20 females) who had had CAL caused by KD. All the patients had undergone MPI and 24-h Holter electrocardiogram at the same time between 2003 and 2012. The age at MPI ranged from 2 to 44 years (median 19 years), and the time from the onset of KD to MPI ranged from 1 to 44 years (median 18 years). We evaluated extent score (ES), summed rest score (SRS), summed stress score (SSS), summed difference score (SDS), and left ventricular ejection fraction (LVEF) by quantitative gated SPECT software. We analyzed which factors related to NSVT using multivariate logistic regression. Further, we calculated the cut-off point for NSVT using receiver operating characteristic curve.
RESULTS
The affecting factors were ES (OR, 0.63, 95%CI, 0.35-0.92, p=0.013) and the interval from the onset of KD to MPI (OR, 0.82, 95%CI, 0.69-0.96, p=0.004). The cut-off points for ES and the interval from the onset of KD were 11% (AUC, 0.931, p<0.001) and 18 years (AUC, 0.732, p=0.007), respectively.
CONCLUSIONS
ES is the strongest parameter for predicting NSVT in the late period. In patients with post-KD, adolescence and young adults with ES ≥11% are at risk of fatal ventricular arrhythmia.
Identifiants
pubmed: 30606680
pii: S0914-5087(18)30350-2
doi: 10.1016/j.jjcc.2018.12.007
pii:
doi:
Substances chimiques
Technetium Tc 99m Sestamibi
971Z4W1S09
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
358-362Informations de copyright
Copyright © 2018 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.