Correlation Between Coronary Artery Damage And Heart Rate Variability In Children With Kawasaki Disease

Objective To investigate the correlation between coronary artery lesions(CAL)and heart rate variability(HRV)in children with Kawasaki disease(KD),and the value of heart rate variability in the early diagnosis of KD complicated with CAL.Methods 111 children with KD who were diagnosed with KD and met the inclusion criteria in the maternal and Child Health Hospital of Inner Mongolia Autonomous Region from December 2018 to December 2021 were selected as the KD group.According to the diagnostic criteria of CAL,the experimental group was divided into31 cases in the CAL group and 80 cases in the non CAL group.The CAL group was divided into 25 cases in the mild CAL group,6 cases in the moderate CAL group and0 cases in the severe CAL group according to the degree of coronary artery damage.99 children who underwent physical examination in the same period were selected as the control group.All groups improved the measurement of long-term HRV index through 24-hour ambulatory electrocardiogram,and collected the data of two groups of children:1)general clinical data:age,gender,etc;2)Echocardiographic results;3)HRV index:time domain index:standard deviation of normal number of intervals(SDNN),standard deviation of per 5 min averages normal number of intervals(SDANN),mean of standard deviation of normal number intervals for 5 minutes(SDNN index),root mean square values of the standard deviation between adjacent normal number of intervals(r MSSD),percentage of differences exceeding 50 ms between adjacent normal number of intervals(p NN50);Frequency domain indicators include low frequency(LF),very low frequency(VLF),high frequency(HF),low frequency to high frequency ratio(LF/HF).The general clinical data and HRV indexes of the experimental group and the control group were analyzed and compared respectively.At the same time,the HRV indexes of CAL group and non CAL group,mild CAL group,moderate CAL group and severe CAL group were compared.SPSS20.0 was used for statistical analysis.The measurement data were described by((?)±SD).The single sample K-S goodness of fit method was used for the normality test.The t-test was used for the comparison between the two groups with normal distribution,The adoption rate of counting data is statistically described,and the statistical inference is adoptedχ~2inspection.Univariate statistically significant indicators were included in multivariate logistic stepwise regression analysis.Results 1)There was no significant difference in age and sex between the KD group and the control group(P>0.05);There was no significant difference in age and sex between cal group and non cal group(P>0.05).2)The values of SDNN,SDANN,SDNN index,r MSSD,p NN50,VLF,LF and HF in the HRV indexes of children in the KD group were lower than those in the control group,and the LF/HF value was higher than that in the control group(P<0.05).3)The values of SDNN,SDANN and VLF in HRV indexes in CAL group were lower than those in non CAL group(P<0.05),and SDANN was a risk factor for CAL(or:0.875;95%CI:0.768-0.997).4)There was no significant difference in HRV between mild CAL group and moderate CAL group(P>0.05).Conclusion 1)HRV index decreased in children with KD,suggesting that KD children may have ANS dysfunction.2)The values of SDNN,SDANN and VLF in HRV index are lower in children with KD complicated with CAL.It is speculated that HRV index has certain practical value in the diagnosis of KD complicated with CAL,and echocardiography should be rechecked regularly.3)The decrease of SDANN value is an independent risk factor for predicting KD concurrent CAL.