Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Change of coronary artery indices according to coronary dominance pattern in early childhood

  • Lee, Yoon Jin (Department of Pediatrics, College of Medicine, Chungnam National University) ;
  • Park, Kyoung Soo (Department of Pediatrics, College of Medicine, Chungnam National University) ;
  • Kil, Hong Ryang (Department of Pediatrics, College of Medicine, Chungnam National University)
  • 투고 : 2018.10.01
  • 심사 : 2018.11.22
  • 발행 : 2019.06.15
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초록

Purpose: Coronary arterial lesion assessment in children can be difficult, depending on the coronary dominance pattern. Although it is easier to determine coronary dominance with echocardiography in children than in adults, it is still difficult. This study aimed to examine the coronary dominance pattern according to the objective coronary artery (CA) indices. Methods: The CA diameter, aortic valve annulus, and abdominal aorta of 69 children without any cardiovascular disease were measured with cross-sectional echocardiography at Chungnam National University Hospital. To evaluate the coronary dominance pattern, echocardiography was primarily used; additionally, coronary computed tomographic angiography or coronary angiography (CAG). Coronary dominance was determined according to the status of the CA that gives rise to the posterior descending artery. Results: The mean age was $4.02{\pm}2.78years$, and the mean body surface area (BSA) was $0.70{\pm}0.22m^2$. Right dominance was present in 78% and left in 22% of the subjects. In those with left dominance, the CA to aortic valve annulus diameter ratio was $0.125{\pm}0.021$ in the right coronary artery (RCA) and $0.255{\pm}0.032$ in the left coronary artery (LCA). In those with right dominance, the corresponding ratio was $0.168{\pm}0.028$ in the RCA and $0.216{\pm}0.030$ in the LCA (P<0.05). Significant differences were also found in the diametric ratios of the CA to BSA and abdominal aorta (P<0.05). Conclusion: The CA indices showed significant difference according to the coronary dominance pattern in early childhood. It is possible to indirectly determine the coronary dominance pattern with the CA indices in children using echocardiography. The accuracy of coronary artery lesion diagnosis can be improved by taking coronary dominance into account.

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참고문헌

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피인용 문헌

  1. Importance of coronary artery dominance in children to determine coronary artery dilatation vol.62, pp.6, 2019, https://doi.org/10.3345/kjp.2019.00066