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Z-score regression model for coronary artery diameter in healthy Chinese Han children
Yanzhang Yang1, Li Wang2, Yanfang Yang3
1Department of Pediatrics, 117872Hebei General Hospital, Shijiazhuang, Hebei, PR China.
Insights
A new square root model accurately calculates coronary artery Z-scores in children, aiding Kawasaki disease diagnosis. This reference tool helps identify coronary artery distension in pediatric patients.
Area of Science:
- Pediatric cardiology
- Medical imaging
- Biostatistics
Background:
- Coronary artery aneurysms and distension are significant complications in children diagnosed with Kawasaki disease.
- Accurate assessment of coronary artery diameter is crucial for early detection and management.
Purpose of the Study:
- To develop a reliable Z-score regression model for pediatric coronary artery diameter.
- Establish a normative reference for evaluating coronary artery dimensions in children.
Main Methods:
- Retrospective analysis of 509 children with normal cardiac structures.
- Echocardiographic measurement of major coronary arteries (right, left main, LAD, circumflex).
- Development and comparison of various regression models (linear, exponential, logarithmic, power, square root) using Pearson correlation analysis.
Main Results:
- Coronary artery diameters showed significant correlations with age, height, body mass, and body surface area (BSA).
- The square root and exponential regression models demonstrated superior performance with higher adjusted determination coefficients.
- Z-scores derived from the square root and exponential models followed a normal distribution.
Conclusions:
- The square root regression model is proposed as the optimal equation for calculating coronary artery Z-scores in Chinese Han children.
- This validated model can significantly aid in diagnosing coronary artery distension in children with suspected Kawasaki disease.
Background:
Coronary artery distension and aneurysm are complications of Kawasaki disease in children.
Purpose:
To develop a Z-score regression model for coronary artery diameter in children that could be used as reference.
Material And Methods:
This retrospective analysis included children with normal heart structure between March 2013 and April 2017. Body surface area (BSA) was calculated. The diameters of the right coronary, left main coronary, left anterior descending, and circumflex arteries were measured by echocardiography. Pearson correlation analysis was used to establish linear, exponential, logarithmic, power, and square root regression models.
Results:
The analysis included 509 children (280 boys) aged 1 day to 15.2 years. Coronary artery diameters were significantly correlated with age, height, body mass, BSA, and (r = 0.663-0.826; P < 0.05), with a stronger correlation for than BSA (P < 0.05). The adjusted determination coefficients () were higher for the exponential and square root models than for the other models (P < 0.05). The random error term variance was constant for the exponential model (P > 0.05), and processing with the weighted least-square methods eliminated heteroscedasticity in the other models. The Z-scores were normally distributed for the exponential and square root models (P > 0.05).
Conclusion:
Overall, the square root model was the optimal equation for the calculation of coronary artery Z-score in Chinese Han children. This model could be used to facilitate the diagnosis of coronary artery distension in children with suspected Kawasaki disease.
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