幼儿冠状动脉优势型冠状动脉指数的变化。

Korean Journal of Pediatrics Pub Date : 2019-06-01 Epub Date: 2018-11-22 DOI:10.3345/kjp.2018.07129
Yoon Jin Lee, Kyoung Soo Park, Hong Ryang Kil
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引用次数: 2

摘要

目的:儿童冠状动脉病变评估可能是困难的,取决于冠状动脉优势模式。虽然用超声心动图确定儿童冠状动脉优势比成人更容易,但仍然很困难。本研究旨在根据客观冠状动脉(CA)指数,探讨冠状动脉优势模式。方法:在忠南大学医院对69例无心血管疾病的儿童进行主动脉瓣直径、主动脉瓣环和腹主动脉的横断超声心动图测量。为了评估冠状动脉优势型,主要使用超声心动图;此外,冠状动脉计算机断层血管造影或冠状动脉血管造影(CAG)。根据产生后降支的CA的状态来确定冠状动脉优势。结果:平均年龄4.02±2.78岁,平均体表面积(BSA) 0.70±0.22 m2。78%的人倾向于右脑,22%的人倾向于左脑。左优势组右冠状动脉(RCA)主动脉瓣环径比为0.125±0.021,左冠状动脉(LCA)主动脉瓣环径比为0.255±0.032。右优势型患儿左冠状动脉的比值为0.168±0.028,右优势型患儿左冠状动脉的比值为0.216±0.030 (p)。利用超声心动图可以通过CA指数间接确定儿童冠状动脉优势型。考虑冠状动脉优势可以提高冠状动脉病变诊断的准确性。
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Change of coronary artery indices according to coronary dominance pattern in early childhood.

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.

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审稿时长
12 weeks
期刊介绍: Korean J Pediatr covers clinical and research works relevant to all aspects of child healthcare. The journal aims to serve pediatricians through the prompt publication of significant advances in any field of pediatrics and to rapidly disseminate recently updated knowledge to the public. Additionally, it will initiate dynamic, international, academic discussions concerning the major topics related to pediatrics. Manuscripts are categorized as review articles, original articles, and case reports. Areas of specific interest include: Growth and development, Neonatology, Pediatric neurology, Pediatric nephrology, Pediatric endocrinology, Pediatric cardiology, Pediatric allergy, Pediatric pulmonology, Pediatric infectious diseases, Pediatric immunology, Pediatric hemato-oncology, Pediatric gastroenterology, Nutrition, Human genetics, Metabolic diseases, Adolescence medicine, General pediatrics.
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