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Korean J Pediatr 2017 November;60(11) :373-378.
Published online 2017 November 15.       
A comparative study of established z score models for coronary artery diameters in 181 healthy Korean children
Kyungguk Ryu, Jeong Jin Yu, Hyun Ok Jun, Eun Jung Shin, Young Hee Heo, Jae Suk Baek, Young-Hwue Kim, Jae-Kon Ko
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Corresponding Author: Jeong Jin Yu ,Tel: +82-2-3010-3924, Fax: +82-2-473-3725, Email:
Copyright © 2017 by The Korean Pediatric Society
Purpose: The aim of this study was to investigate the statistical properties of four previously developed pediatric coronary artery z score models in healthy Korean children.
Methods: The study subjects were 181 healthy Korean children, whose age ranged from 1 month to 15 years. The diameter of each coronary artery was measured using 2-dimensional echocardiography and converted to the z score in the four models (McCrindle, Olivieri, Dallaire, and Japanese model). Descriptive statistical analyses and 1-sample t tests were performed.
Results: All calculated z scores had P values of 0.050 using the Kolmogorov-Smirnov test. The one sample t test showed that the mean z scores did not converge to zero except in 1 model, and the mean right coronary artery (RCA) z score was less than zero in all 4 models. The smaller RCA diameter in this study could be associated with the more distal measuring point used to avoid the conal branch. The percentage of subjects with extreme z score values (2.0 and 2.5) for the left main coronary artery (LMCA) seems to be higher in the Dallaire (4.9% and 3.3%) and Japanese models (7.1% and 3.8%).
Conclusion: All 4 models showed statistical feasibility of normal distribution. More precise instructions would be needed for the measurement of the RCA. The higher percentage of extreme z scores for the LMCA is compatible with the basic understanding of anatomic variation in the LMCA.
Keywords: z score | Coronary artery diameters | Korean children | Kawasaki disease
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