Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A comparative study of established z score models for coronary artery diameters in 181 healthy Korean children

  • Ryu, Kyungguk (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yu, Jeong Jin (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jun, Hyun Ok (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Shin, Eun Jung (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Heo, Young Hee (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Baek, Jae Suk (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Young-Hwue (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ko, Jae-Kon (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2017.07.28
  • Accepted : 2017.09.21
  • Published : 2017.11.15
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Abstract

Purpose: The aim of this study was to investigate the statistical properties of four previously developed pediatric coronary artery z score models in healthy Korean children. Methods: The study subjects were 181 healthy Korean children, whose age ranged from 1 month to 15 years. The diameter of each coronary artery was measured using 2-dimensional echocardiography and converted to the z score in the four models (McCrindle, Olivieri, Dallaire, and Japanese model). Descriptive statistical analyses and 1-sample t tests were performed. Results: All calculated z scores had P values of ${\geq}0.050$ using the Kolmogorov-Smirnov test. The one sample t test showed that the mean z scores did not converge to zero except in 1 model, and the mean right coronary artery (RCA) z score was less than zero in all 4 models. The smaller RCA diameter in this study could be associated with the more distal measuring point used to avoid the conal branch. The percentage of subjects with extreme z score values (${\geq}2.0$ and ${\geq}2.5$) for the left main coronary artery (LMCA) seems to be higher in the Dallaire (4.9% and 3.3%) and Japanese models (7.1% and 3.8%). Conclusion: All 4 models showed statistical feasibility of normal distribution. More precise instructions would be needed for the measurement of the RCA. The higher percentage of extreme z scores for the LMCA is compatible with the basic understanding of anatomic variation in the LMCA.

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