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Pediatric continuous reference intervals of coronary artery diameter by echocardiography in healthy Chinese children
Lin Zheng1, Ya-Guang Peng2, Jiao Yang1
1Department of Echocardiography, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
Insights
This study establishes body surface area (BSA)-dependent Z-score reference intervals for coronary artery diameters in healthy Chinese children using the LMS method. A web calculator is available for clinical use.
Area of Science:
- Pediatric Cardiology
- Medical Imaging
- Biostatistics
Background:
- Echocardiography is the primary non-invasive method for assessing pediatric coronary artery diameter.
- Body surface area (BSA)-dependent Z-scores offer a more objective evaluation than absolute measurements.
- The Lambda-Mu-Sigma (LMS) method is an internationally accepted standard for creating continuous reference intervals.
Purpose of the Study:
- To establish BSA-dependent Z-score continuous reference intervals for coronary artery diameters in healthy Chinese children.
- To provide ethnicity-specific reference data for the Chinese pediatric population.
- To develop a validated model and practical tool for clinical application.
Main Methods:
- Echocardiography was used to measure coronary artery diameters in 1221 healthy Chinese children.
- The Lambda-Mu-Sigma (LMS) method was employed for modeling.
- The Haycock equation was used for Body Surface Area (BSA) estimation.
Main Results:
- BSA-dependent Z-score continuous reference intervals for six coronary artery segments (LMCA, LAD, LCX, RCA-pro, RCA-mid, RCA-dis) were established.
- The LMS-based model demonstrated successful internal and external validation.
- The study provides updated, ethnicity-specific reference intervals for Chinese children.
Conclusions:
- The study successfully generated BSA-dependent Z-score continuous reference intervals for coronary artery diameters in healthy Chinese children.
- A web-based Z-score calculator is available for convenient clinical use by physicians.
- These findings facilitate more accurate assessments and subsequent external validations in larger populations.
Abstract:
The aim of this study was to establish body surface area (BSA)-dependent Z-score continuous reference intervals of coronary artery diameter measured by Echocardiography in healthy Chinese children population. Echocardiography measured 1221 healthy Chinese children's coronary artery diameters, including the LMCA, LAD, LCX, RCA-pro, RCA-mid, and RCA-dis. We employed the LMS (Lambda-Mu-Sigma) method for the model and the Haycock equation for the BSA estimation. The coronary artery diameter Z-score continuous reference intervals were established using the LMS method and passed the internal and external validation.
Conclusions:
The study outcome provides BSA-dependent Z-score continuous reference intervals for the coronary artery diameters in healthy Chinese children. There is a web Z-score calculator with convenient application for clinicians and ultrasound doctors, facilitating subsequent external validations in a larger population.
What Is Known:
• Echocardiography is the primary non‑invasive modality for assessing coronary artery (CA) diameter in children, and body surface area (BSA)‑dependent Z‑scores provide a more objective evaluation than absolute values. • The LMS (Lambda‑Mu‑Sigma) method is an internationally accepted approach for establishing continuous reference intervals, as used in the WHO child growth standards.
What Is New:
• This study establishes BSA‑dependent Z‑score continuous reference intervals for six coronary artery segments (LMCA, LAD, LCX, RCA‑pro, RCA‑mid, RCA‑dis) specifically in healthy Chinese children aged 0 days to 18 years. • It provides a validated, LMS‑based model along with an online Z‑score calculator and a fully reproducible computational procedure, addressing the lack of updated, ethnicity‑specific continuous reference intervals for the Chinese pediatric population.
