Korean J Pediatr.  2019 Jun;62(6):240-243. 10.3345/kjp.2018.07129.

Change of coronary artery indices according to coronary dominance pattern in early childhood

Affiliations
  • 1Department of Pediatrics, College of Medicine, Chungnam National University, Daejeon, Korea. gilhong@cnu.ac.kr

Abstract

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±2.78 years, and the mean body surface area (BSA) was 0.70±0.22 m². 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±0.021 in the right coronary artery (RCA) and 0.255±0.032 in the left coronary artery (LCA). In those with right dominance, the corresponding ratio was 0.168±0.028 in the RCA and 0.216±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.

Keyword

Kawasaki disease; Coronary artery

MeSH Terms

Adult
Angiography
Aorta, Abdominal
Aortic Valve
Arteries
Body Surface Area
Cardiovascular Diseases
Child
Chungcheongnam-do
Coronary Angiography
Coronary Vessels*
Diagnosis
Echocardiography
Humans
Mucocutaneous Lymph Node Syndrome
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