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Screening of Coronary Artery Origin by Echocardiography: Definition of Normal (and Abnormal) Take-Off by Standard Echocardiographic Views in a Healthy Pediatric Population

Background: Echocardiographic screening of anomalous coronary artery origin is of increasing interest for children participating in sport activities. However, criteria to define normal coronary artery origins in children are poorly defined. Thus, the aim of the present investigation is to define the...

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Autores principales: Cantinotti, Massimiliano, Marchese, Pietro, Franchi, Eliana, Pizzuto, Alessandra, Corana, Giulia, Viacava, Cecilia, Barnes, Benjamin T., Kutty, Shelby, Assanta, Nadia, McMahon, Colin J., Koestenberger, Martin, Giordano, Raffaele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9601645/
https://www.ncbi.nlm.nih.gov/pubmed/36292337
http://dx.doi.org/10.3390/healthcare10101890
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author Cantinotti, Massimiliano
Marchese, Pietro
Franchi, Eliana
Pizzuto, Alessandra
Corana, Giulia
Viacava, Cecilia
Barnes, Benjamin T.
Kutty, Shelby
Assanta, Nadia
McMahon, Colin J.
Koestenberger, Martin
Giordano, Raffaele
author_facet Cantinotti, Massimiliano
Marchese, Pietro
Franchi, Eliana
Pizzuto, Alessandra
Corana, Giulia
Viacava, Cecilia
Barnes, Benjamin T.
Kutty, Shelby
Assanta, Nadia
McMahon, Colin J.
Koestenberger, Martin
Giordano, Raffaele
author_sort Cantinotti, Massimiliano
collection PubMed
description Background: Echocardiographic screening of anomalous coronary artery origin is of increasing interest for children participating in sport activities. However, criteria to define normal coronary artery origins in children are poorly defined. Thus, the aim of the present investigation is to define the normal origin and angle of emergence of coronary arteries by echocardiography in healthy children. Materials and methods: The distances of the left main and right coronary artery (LMCA, RCA) origins from the aortic annulus were measured in the parasternal long-axis view (LAX). The angle of coronary artery emergence was measured in the parasternal short-axis view (SAX). Results: A total of 700 healthy subjects (mean age: 9.53 ± 5.95 years; range: 1 day–17.98 years) were prospectively enrolled. The distance of the RCA and LMCA from the aortic annulus correlated with body surface area, and nomograms (Z-scores) were generated. The RCA origin was below the sinotubular junction (STJ) in 605 patients (86.43%), at the STJ in 66 patients (9.43%), and above the STJ in 29 patients (4.14%). The LMCA origin was below the STJ in 671 patients (95.86%), at the STJ in 12 patients (1.71%), and above the STJ in 17 patients (2.43%). With respect to the RCA, an emergence angle < 18.5° in the SAX predicted a high take-off. with a sensitivity of 98.3% and a specificity of 93.1% (AUC 0.998). With respect to the LMCA, an emergence angle > 119.5° in the SAX predicted a high take-off, with a sensitivity of 70.6% and a specificity of 82.4% (AUC 0.799). Conclusion: This study establishes nomograms for LMCA and RCA origin in standard echocardiographic projections in healthy children.
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spelling pubmed-96016452022-10-27 Screening of Coronary Artery Origin by Echocardiography: Definition of Normal (and Abnormal) Take-Off by Standard Echocardiographic Views in a Healthy Pediatric Population Cantinotti, Massimiliano Marchese, Pietro Franchi, Eliana Pizzuto, Alessandra Corana, Giulia Viacava, Cecilia Barnes, Benjamin T. Kutty, Shelby Assanta, Nadia McMahon, Colin J. Koestenberger, Martin Giordano, Raffaele Healthcare (Basel) Article Background: Echocardiographic screening of anomalous coronary artery origin is of increasing interest for children participating in sport activities. However, criteria to define normal coronary artery origins in children are poorly defined. Thus, the aim of the present investigation is to define the normal origin and angle of emergence of coronary arteries by echocardiography in healthy children. Materials and methods: The distances of the left main and right coronary artery (LMCA, RCA) origins from the aortic annulus were measured in the parasternal long-axis view (LAX). The angle of coronary artery emergence was measured in the parasternal short-axis view (SAX). Results: A total of 700 healthy subjects (mean age: 9.53 ± 5.95 years; range: 1 day–17.98 years) were prospectively enrolled. The distance of the RCA and LMCA from the aortic annulus correlated with body surface area, and nomograms (Z-scores) were generated. The RCA origin was below the sinotubular junction (STJ) in 605 patients (86.43%), at the STJ in 66 patients (9.43%), and above the STJ in 29 patients (4.14%). The LMCA origin was below the STJ in 671 patients (95.86%), at the STJ in 12 patients (1.71%), and above the STJ in 17 patients (2.43%). With respect to the RCA, an emergence angle < 18.5° in the SAX predicted a high take-off. with a sensitivity of 98.3% and a specificity of 93.1% (AUC 0.998). With respect to the LMCA, an emergence angle > 119.5° in the SAX predicted a high take-off, with a sensitivity of 70.6% and a specificity of 82.4% (AUC 0.799). Conclusion: This study establishes nomograms for LMCA and RCA origin in standard echocardiographic projections in healthy children. MDPI 2022-09-28 /pmc/articles/PMC9601645/ /pubmed/36292337 http://dx.doi.org/10.3390/healthcare10101890 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cantinotti, Massimiliano
Marchese, Pietro
Franchi, Eliana
Pizzuto, Alessandra
Corana, Giulia
Viacava, Cecilia
Barnes, Benjamin T.
Kutty, Shelby
Assanta, Nadia
McMahon, Colin J.
Koestenberger, Martin
Giordano, Raffaele
Screening of Coronary Artery Origin by Echocardiography: Definition of Normal (and Abnormal) Take-Off by Standard Echocardiographic Views in a Healthy Pediatric Population
title Screening of Coronary Artery Origin by Echocardiography: Definition of Normal (and Abnormal) Take-Off by Standard Echocardiographic Views in a Healthy Pediatric Population
title_full Screening of Coronary Artery Origin by Echocardiography: Definition of Normal (and Abnormal) Take-Off by Standard Echocardiographic Views in a Healthy Pediatric Population
title_fullStr Screening of Coronary Artery Origin by Echocardiography: Definition of Normal (and Abnormal) Take-Off by Standard Echocardiographic Views in a Healthy Pediatric Population
title_full_unstemmed Screening of Coronary Artery Origin by Echocardiography: Definition of Normal (and Abnormal) Take-Off by Standard Echocardiographic Views in a Healthy Pediatric Population
title_short Screening of Coronary Artery Origin by Echocardiography: Definition of Normal (and Abnormal) Take-Off by Standard Echocardiographic Views in a Healthy Pediatric Population
title_sort screening of coronary artery origin by echocardiography: definition of normal (and abnormal) take-off by standard echocardiographic views in a healthy pediatric population
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9601645/
https://www.ncbi.nlm.nih.gov/pubmed/36292337
http://dx.doi.org/10.3390/healthcare10101890
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