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Dimensions of the coronary arteries in children
E Pesonen1, J Hirvonen, K Karkola
1Children's Hospital, First Department of Pediatrics, University of Helsinki, Finland.
Insights
Coronary artery narrowing in children is common, even in the youngest. This narrowing correlates with vessel size, not age, and provides normal values for Finnish children.
Area of Science:
- Pediatric Pathology
- Cardiovascular Anatomy
- Forensic Medicine
Background:
- Coronary artery dimensions and potential narrowing in children are not well-established.
- Understanding normal pediatric coronary artery development is crucial for identifying pathological changes.
Purpose of the Study:
- To establish normal reference values for coronary artery dimensions in Finnish children.
- To investigate the relationship between coronary artery size, age, and the extent of arterial lumen narrowing.
Main Methods:
- Autopsy measurements of coronary artery dimensions (outer and inner radii) in 106 children.
- Analysis of arterial wall thickness (media and intima).
- Correlation of dimensions and narrowing with age and body weight.
Main Results:
- Coronary artery outer and inner radii increase significantly with age from 1 to 15 years.
- Arterial wall thickness, particularly the intima, increases with age and artery size.
- Substantial coronary artery narrowing was observed across all age groups, correlating with vessel size, not chronological age.
Conclusions:
- The study provides essential normative data for coronary artery dimensions in Finnish children.
- Vessel size, rather than age, is the primary determinant of coronary artery narrowing in this pediatric cohort.
- These findings are vital for accurate interpretation in pediatric forensic and pathological examinations.
Abstract:
The extent of narrowing of the coronary arteries was measured in a series of 106 children who died accidentally. The outer radius of left main stem coronary artery increases from 1.06 mm at the age of 1 to 1.67 mm at 15. The left anterior descending branch increased with age from 0.70 to 1.35 mm and the inner radius from 0.55 to 1.10 mm. The mean thickness of the media and intima also increased with age; the correlation between thickness and weight was less pronounced. The coronary arteries thickened concomitantly with the size of the artery but that was due mainly to thickening of the intima. Substantial narrowing was found in the youngest age groups and the extent did not correlate with age but with the size of the vessel. The greatest narrowing was 57% of the arterial lumen. The measured dimensions will serve as normal values for the coronary arteries in Finnish children at autopsy.