Screening of Coronary Artery Origin by Echocardiography: Definition of Normal (and Abnormal) Take-Off by Standard Echocardiographic Views in a Healthy Pediatric Population
Abstract
:1. Background
2. Methods
2.1. Echocardiographic Protocol
- -
- “Above the STJ” when the origin was >100% of the distance from the AO annulus to the STJ;
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- “At the level of STJ” when the origin was within 5% of the distance from the AO annulus to the STJ; and
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- “Below the STJ” when the value was <5% of the distance from the AO annulus to the STJ.
2.2. Statistical Methods
3. Results
3.1. Feasibility
3.2. Percentage of Major and Minor Anomalies
3.3. Coronary Artery Origin: Distance from the Aortic Annulus
3.3.1. Nomograms
3.3.2. Comparison of Measurement Methods
3.4. Coronary Arteries: Distance from STJ
3.4.1. Right Coronary Artery (RCA)
3.4.2. Left Main Coronary Artery (LMCA)
3.5. Correlation between Angle of Coronary Emergence in SAX and High Take-Off
3.5.1. Right Coronary Artery (RCA): High Take-Off and Reduced Angle in SAX
3.5.2. Left Main Coronary Artery (LMCA): High Take-Off and Increased Angle in SAX
3.6. Reproducibility
4. Discussion
5. Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Male (n = 388) | Female (n = 312) | Total (n = 700) |
---|---|---|---|
Demographic Data | |||
Age, years (range) | 9.07 ± 4.97 (0–17.87) | 8.21 ± 4.87 (0–17.98) | 9.53 ± 5.95 (0–17.98) |
Weight, kg (range) | 36.59 ± 21.14 (2.57–110) | 32.7 ± 19.03 (3–82) | 36.62 ± 20.33 (2.57–110) |
Height, cm (range) | 132.33 ± 34.96 (11–196) | 128.47 ± 33.51 (48–178) | 130.7 ± 51.6 (46–196) |
BSA Haycock, m2 (range) | 1.14 ± 0.46 (0.18–2.43) | 1.05 ± 0.45 (0.21–2) | 1.1 ± 0.46 (0.18–2.43) |
Anomalous aortic origin of coronary arteries | |||
LAD and CFx: separate ostia, nr | 9 | 1 | 10 |
CFx from right coronary sinus, nr | 3 | 0 | 3 |
Single ostium from the right coronary sinus, nr | 2 | 1 | 3 |
Coronary artery fistula, nr | 1 | 0 | 1 |
Coronary artery position within the aortic root | |||
RCA above the STJ, nr | 15 | 14 | 29 |
RCA at the level of the STJ, nr | 29 | 37 | 66 |
RCA below the STJ, nr | 317 | 288 | 605 |
LMCA above the STJ, nr | 8 | 9 | 17 |
LMCA at the level of the STJ, nr | 6 | 6 | 12 |
LMCA below the STJ, nr | 344 | 327 | 671 |
(A) RCA position within the aortic root in absolute value, percentage terms, and indexed by BSA. | |||||||
Mean | SD | Min | Max | Median | IQR 25th | IQR 75th | |
RCA Below the STJ | |||||||
RCA distance from AoV (mm)—oblique | 9.53 | 3.50 | 1.83 | 26.10 | 9.70 | 6.80 | 11.90 |
RCA distance from AoV (mm/m2) | 9.24 | 3.59 | 2.27 | 29.53 | 8.73 | 6.92 | 10.78 |
RCA distance from AoV (%) | 60.45 | 14.08 | 15.64 | 90.31 | 62.98 | 51.88 | 70.85 |
RCA distance from STJ (mm) | 4.32 | 2.62 | 0.44 | 14.99 | 3.75 | 2.29 | 6.00 |
RCA distance from STJ (mm/m2) | 4.56 | 3.53 | 0.56 | 27.72 | 3.70 | 2.07 | 5.85 |
RCA distance from STJ (%) | 28.22 | 15.83 | 5.05 | 82.85 | 25.86 | 15.56 | 38.17 |
RCA diameter (mm) | 2.46 | 0.82 | 0.60 | 7.50 | 2.34 | 1.90 | 2.97 |
RCA emergence degree (°) | 35.73 | 8.99 | 9.7 | 116.6 | 34.75 | 30 | 40.78 |
RCA at the STJ | |||||||
RCA distance from AoV (mm)—oblique | 12.21 | 2.78 | 5.47 | 18.02 | 12.40 | 10.90 | 13.70 |
RCA distance from AoV (mm/m2) | 11.34 | 4.12 | 6.59 | 30.58 | 10.64 | 8.76 | 12.78 |
RCA distance from AoV (%) | 79.66 | 5.50 | 68.18 | 98.47 | 80.09 | 76.67 | 83.01 |
RCA distance from STJ (mm) | 0.40 | 0.25 | 0.00 | 0.94 | 0.40 | 0.20 | 0.60 |
RCA distance from STJ (mm/m2) | 0.37 | 0.25 | 0.00 | 1.02 | 0.34 | 0.17 | 0.55 |
RCA distance from STJ (%) | 2.61 | 1.48 | 0.00 | 4.82 | 2.74 | 1.48 | 3.92 |
RCA diameter (mm) | 2.83 | 0.97 | 1.00 | 5.40 | 2.67 | 2.21 | 3.50 |
RCA emergence degree (°) | 30.97 | 9.8 | 12.5 | 54.5 | 30.15 | 23.83 | 38.85 |
RCA above the STJ | |||||||
RCA distance from AoV (mm)—oblique | 13.29 | 3.55 | 4.70 | 19.50 | 12.70 | 10.70 | 15.85 |
RCA distance from AoV (mm/m2) | 12.28 | 3.42 | 6.63 | 20.63 | 11.40 | 9.85 | 13.27 |
RCA distance from AoV (%) | 89.80 | 9.54 | 73.91 | 106.58 | 88.79 | 81.28 | 99.46 |
RCA distance from STJ (mm) | −1.40 | 1.36 | −4.46 | −0.01 | −1.04 | −2.29 | −0.23 |
RCA distance from STJ (mm/m2) | −1.32 | 1.21 | −4.27 | −0.01 | −0.90 | −2.34 | −0.17 |
RCA distance from STJ (%) | −10.02 | 9.20 | −26.39 | −0.07 | −7.37 | −19.88 | −1.41 |
RCA diameter (mm) | 3.01 | 0.95 | 1.36 | 4.90 | 3.00 | 2.43 | 3.79 |
RCA emergence degree (°) | 7.27 | 14.06 | −37.2 | 18 | 13.2 | 4.4 | 16.7 |
(B) LMCA position within the aortic root in absolute value, percentage terms, and indexed by BSA. | |||||||
LMCA below the STJ | |||||||
LMCA distance from AoV (mm)—oblique | 4.86 | 2.35 | 1.00 | 16.80 | 4.42 | 3.24 | 5.70 |
LMCA distance from AoV (mm/m2) | 4.78 | 2.38 | 1.08 | 16.55 | 4.14 | 3.18 | 5.64 |
LMCA distance from AoV (%) | 31.57 | 12.73 | 8.04 | 93.71 | 28.50 | 23.26 | 36.34 |
LMCA distance from STJ (mm) | 8.62 | 3.62 | 0.73 | 22.49 | 8.49 | 6.00 | 10.90 |
LMCA distance from STJ (mm/m2) | 8.68 | 4.29 | 0.51 | 31.10 | 8.09 | 5.88 | 10.59 |
LMCA distance from STJ (%) | 55.27 | 16.26 | 3.86 | 88.99 | 56.54 | 47.74 | 66.15 |
LMCA diameter (mm) | 2.68 | 0.88 | 0.76 | 6.00 | 2.60 | 2.00 | 3.21 |
LMCA emergence degree (°) | 111.97 | 12.59 | 11.60 | 163.00 | 113.00 | 105.00 | 120.00 |
LMCA at the STJ | |||||||
LMCA distance from AoV (mm)—oblique | 14.65 | 2.22 | 11.60 | 17.90 | 14.45 | 12.80 | 16.58 |
LMCA distance from AoV (mm/m2) | 10.03 | 1.23 | 8.48 | 12.33 | 9.85 | 8.99 | 10.83 |
LMCA distance from AoV (%) | 79.22 | 5.51 | 67.03 | 84.57 | 81.69 | 75.42 | 82.96 |
LMCA distance from STJ (mm) | 0.30 | 0.19 | 0.00 | 0.50 | 0.30 | 0.16 | 0.50 |
LMCA distance from STJ (mm/m2) | 0.19 | 0.14 | 0.00 | 0.42 | 0.17 | 0.07 | 0.28 |
LMCA distance from STJ (%) | 1.65 | 1.07 | 0.00 | 3.18 | 1.70 | 0.74 | 2.57 |
LMCA diameter (mm) | 3.52 | 0.97 | 2.64 | 5.50 | 3.15 | 2.74 | 4.43 |
LMCA emergence degree (°) | 131.15 | 12.20 | 113.60 | 152.60 | 130.55 | 121.23 | 140.28 |
LMCA above the STJ | |||||||
LMCA distance from AoV (mm)—oblique | 13.24 | 3.61 | 5.20 | 19.60 | 13.60 | 12.44 | 15.39 |
LMCA distance from AoV (mm/m2) | 11.68 | 3.02 | 3.10 | 16.14 | 12.02 | 10.59 | 13.08 |
LMCA distance from AoV (%) | 90.35 | 17.50 | 28.71 | 104.00 | 96.48 | 86.34 | 98.65 |
LMCA distance from STJ (mm) | −3.77 | 7.69 | −33.40 | −0.10 | −2.10 | −2.86 | −1.20 |
LMCA distance from STJ (mm/m2) | −2.65 | 4.30 | −17.87 | −0.13 | −1.74 | −2.34 | −0.90 |
LMCA distance from STJ (%) | −23.81 | 38.58 | −165.35 | −0.73 | −14.29 | −17.87 | −9.03 |
LMCA diameter (mm) | 5.44 | 10.96 | 1.50 | 47.80 | 2.60 | 2.35 | 3.05 |
LMCA emergence degree (°) | 129.34 | 18.45 | 94.40 | 164.00 | 131.40 | 114.00 | 141.55 |
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Cantinotti, M.; Marchese, P.; Franchi, E.; Pizzuto, A.; Corana, G.; Viacava, C.; Barnes, B.T.; Kutty, S.; Assanta, N.; McMahon, C.J.; et al. Screening of Coronary Artery Origin by Echocardiography: Definition of Normal (and Abnormal) Take-Off by Standard Echocardiographic Views in a Healthy Pediatric Population. Healthcare 2022, 10, 1890. https://doi.org/10.3390/healthcare10101890
Cantinotti M, Marchese P, Franchi E, Pizzuto A, Corana G, Viacava C, Barnes BT, Kutty S, Assanta N, McMahon CJ, et al. Screening of Coronary Artery Origin by Echocardiography: Definition of Normal (and Abnormal) Take-Off by Standard Echocardiographic Views in a Healthy Pediatric Population. Healthcare. 2022; 10(10):1890. https://doi.org/10.3390/healthcare10101890
Chicago/Turabian StyleCantinotti, Massimiliano, Pietro Marchese, Eliana Franchi, Alessandra Pizzuto, Giulia Corana, Cecilia Viacava, Benjamin T. Barnes, Shelby Kutty, Nadia Assanta, Colin J. McMahon, and et al. 2022. "Screening of Coronary Artery Origin by Echocardiography: Definition of Normal (and Abnormal) Take-Off by Standard Echocardiographic Views in a Healthy Pediatric Population" Healthcare 10, no. 10: 1890. https://doi.org/10.3390/healthcare10101890
APA StyleCantinotti, M., Marchese, P., Franchi, E., Pizzuto, A., Corana, G., Viacava, C., Barnes, B. T., Kutty, S., Assanta, N., McMahon, C. J., Koestenberger, M., & Giordano, R. (2022). Screening of Coronary Artery Origin by Echocardiography: Definition of Normal (and Abnormal) Take-Off by Standard Echocardiographic Views in a Healthy Pediatric Population. Healthcare, 10(10), 1890. https://doi.org/10.3390/healthcare10101890