title: Application of signal-averaged electrocardiogram to myocardial damage in the late stage of Kawasaki disease.
abstract: BACKGROUND
  Myocardial damage occurs in the late stage of Kawasaki disease (KD) regardless of whether coronary artery lesions (CALs) are present.
  
  
  RESULTS
  A signal-averaged electrocardiogram (ECG) was performed in 23 patients who were in the late stage of KD (CAL was found in 12 and no CAL (non-CAL) was found in 11) and 10 healthy controls. Filtered QRS duration and the root-mean-square voltage in the last 40 ms of the QRS complex were measured using time-domain analysis. Additionally, the area ratio (AR), (area of 20-50 Hz)/(area of 0-20 Hz) x100, was calculated by frequency domain analysis. These findings were compared with the clinical data and histopathological findings. In time-domain analysis, there were no significant differences among the 3 groups. In frequency domain analysis, the AR in CAL was significantly higher than that in the other 2 groups. Furthermore, all 4 patients who underwent an endomyocardial biopsy showed a high AR and abnormal histopathological features.
  
  
  CONCLUSIONS
  The findings of the present study suggest that patients in the late stage of KD have abnormal findings on signal-averaged ECG even without stenotic lesions, arrhythmia or ischemia, a condition that might reflect histopathological changes in the myocardium in the late stage of KD.
authors.affiliation: Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan. mtakeuchi@chp.toyonaka.osaka.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Tohru
authors.initials: T
authors.lastname: Matsushita
authors.forename: Shunji
authors.initials: S
authors.lastname: Kurotobi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sano
authors.forename: Shigetoyo
authors.initials: S
authors.lastname: Kogaki
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ozono
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology; D018450:Disease Progression; D004562:Electrocardiography / Q000379:methods*; D006321:Heart / Q000503:physiopathology*; D006331:Heart Diseases / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D009206:Myocardium / Q000473:pathology; D011446:Prospective Studies; D012815:Signal Processing, Computer-Assisted