J Korean Med Sci.  2024 Apr;39(16):e144. 10.3346/jkms.2024.39.e144.

Newly Developed Sex-Specific Z Score Model for Coronary Artery Diameter in a Pediatric Population

• Yu JJ
• Choi HJ
• Cho HJ
• Kim SH
• Cheon EJ
• Kim GB
• Eun LY
• Jung SY
• Jun HO
• Woo HO
• Park SA
• Yoon S
• Ko H
• Ban JE
• Choi JW
• Song MS
• Han JW

• KMID: 2555477
• DOI: http://doi.org/10.3346/jkms.2024.39.e144

Abstract

Background
This study aimed to generate a Z score calculation model for coronary artery diameter of normal children and adolescents to be adopted as the standard calculation method with consensus in clinical practice.
Methods
This study was a retrospective, multicenter study that collected data from multiple institutions across South Korea. Data were analyzed to determine the model that best fit the relationship between the diameter of coronary arteries and independent demographic parameters. Linear, power, logarithmic, exponential, and square root polynomial models were tested for best fit.
Results
Data of 2,030 subjects were collected from 16 institutions. Separate calculation models for each sex were developed because the impact of demographic variables on the diameter of coronary arteries differs according to sex. The final model was the polynomial formula with an exponential relationship between the diameter of coronary arteries and body surface area using the DuBois formula.
Conclusion
A new coronary artery diameter Z score model was developed and is anticipated to be applicable in clinical practice. The new model will help establish a consensus-based Z score model.

Keyword

Coronary Artery; Children; Kawasaki Disease; Z Score

Figure

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  Fig. 1 Distribution of frequencies according to age of patients.

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  Fig. 2 Scatter plot of measured value and sex-specific Z score boundaries based on the new model for the diameter of coronary arteries against BSA. LMCA: (A) males, (B) females; LAD: (C) males, (D) females; LCx: (E) males, (F) females; and RCA: (G) males, (H) females.BSA = body surface area, LMCA = left main coronary artery, LAD = left anterior descending coronary artery, LCx = left circumflex coronary artery, RCA = right coronary artery.

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