ABSTRACT
BACKGROUND: The second derivative of the photoplethysmogram (SDPTG) has been verified as a useful method for analyzing pulse wave form in adults; however, there have been few studies on the SDPTG in children. METHODS: We examined age-related alteration of SDPTG (study 1) and the SDPTG response to a vasodilator (study 2). The subjects in study 1 were 36 healthy children aged 0.9-16.0 years. The subjects in study 2 were 13 children aged 5.4-18.9 years with a history of Kawasaki disease. Subjects received an i.v. infusion of 0.568 mg/kg dipyridamole. We assessed the SDPTG by d/a ratio, b/a ratio and aging index (AGI). RESULTS: The d/a ratio increased with advance of age (r= 0.636, P < 0.001), and the b/a ratio and AGI decreased with advance of age (r=-0.343, P < 0.05 and r=-0.678, P < 0.001, respectively). The d/a ratio and AGI were correlated with height (r= 0.523, P < 0.01 and r=-0.623, P < 0.001, respectively), but the b/a ratio was not significantly correlated with height. In study 2, the d/a ratio increased significantly (P≤ 0.05), but the b/a ratio and AGI did not alter. CONCLUSIONS: The SDPTG indices in children show characteristic alterations with advance of age and react to a vasodilator.
Subject(s)
Photoplethysmography , Pulse , Vasodilator Agents/pharmacology , Adolescent , Blood Pressure/physiology , Child , Child, Preschool , Dipyridamole/pharmacology , Female , Heart Rate/physiology , Humans , Infant , Male , Mucocutaneous Lymph Node Syndrome/diagnosis , Photoplethysmography/drug effectsABSTRACT
BACKGROUND: The electron beam computed tomography (EBT) was used as non-invasive methods for estimating mycardial characteristics in patients after onset of Kawasaki disease. METHODS: All of the 22 coronary branches with localized stenosis (LS), and 22 branches without coronary artery lesion after Kawasaki disease were examined for changes of myocardial CT number. In this study, each myocardial region was divided into three parts (endocardial, central, epicardial parts) and the myocardium/lumen (M/L) ratio was calculated. RESULTS: The mean M/L ratio in the endocardial part of early image with LS was significantly lower than the ratios in the other parts of early images with LS (P = 0.0286, P = 0.0069, respectively). and only the mean M/L ratio in the endocardial part was significantly different on images from patients with LS and images from patients without LS (P = 0.0296). Inverse correlations were found in the LS group between coronary artery stenosis rate determined by coronary angiography and M/L ratio in the endocardial part on early images (P = 0.0018, r = -0.614, y = 0.56 -0.605x). CONCLUSIONS: It was possible to quantitatively evalutate myocardial characteristics using EBT. It is suggested that myocardial ischemia progressed from the endocardial region and EBT is useful to detect the endocardial ischemia. We suggested that the rate of coronary stenosis in patients with LS can be estimated by calculating the M/L rations in the endocardial parts of early EBT images. EBT enables accurate evaluation of myocardial characteristics non-invasively.
