New equations and a critical appraisal of coronary artery Z scores in healthy children

J Am Soc Echocardiogr. 2011 Jan;24(1):60-74. doi: 10.1016/j.echo.2010.10.004. Epub 2010 Nov 13.


Background: The aim of this study was to find the best model to obtain valid and normally distributed Z scores for coronary artery (CA) diameters in a large, heterogeneous population of healthy children.

Methods: Echocardiography was performed on 1,033 healthy children. Several regression models were tested with height, weight, body surface area, and aortic valve diameter. The computed Z scores were tested for normal distribution and stability.

Results: CA diameter was best predicted using regression with the square root of body surface area. The weighted least squares method yielded normally distributed and very stable Z-score estimates for all CA segments. In prepubertal children, aortic valve diameter was also a valid predictor of CA diameter.

Conclusions: This study shows two valid methods to estimate Z scores for CA size in children of all ages. Such Z scores are important for risk stratification in patients with Kawasaki disease.

MeSH terms

  • Algorithms*
  • Anatomy, Cross-Sectional / methods*
  • Child
  • Child, Preschool
  • Computer Simulation
  • Coronary Vessels / anatomy & histology*
  • Coronary Vessels / diagnostic imaging*
  • Echocardiography / methods*
  • Female
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods*
  • Infant
  • Male
  • Models, Anatomic*
  • Reference Values
  • Reproducibility of Results
  • Sensitivity and Specificity