Assessment Of Coronary Artery Abnormalities And Variability Ofz-Score Calculation In The Acute Episode Of Kawasaki Disease-A Retrospective Study From China

Background Accurate classification of coronary artery abnormalities (CAAs) is essential for clinical decision-making and long-term management in Kawasaki disease (KD) patients. To date, there are several echocardiographic criteria of CAA assessment. Materials and methods The Japanese Ministry of Health (JMH) criteria and theZ-score criteria from 2004 American Heart Association guidelines were adopted and their detective efficacies for CAAs were compared in 251 Chinese patients with KDZscores were calculated by 6 published methods. Results According to the JMH criteria, 19 (7.57%) KD patients were classified as CAAs during the acute KD episode. However, the detective number of CAAs was highest and had a 0.68-fold increase by the Dallaireet almethod with aZ-score cut point of >= 2.5 as compared with the JMH criteria; in contrast, more than 78.95% of patients with CAAs identified by the JMH criteria had a coronary arteryZscore >= 2.5. All 6 differentZ-score methods had satisfactory accuracies with a range from 93.23% to 97.61% in screening CAAs. For the 19 patients with CAAs identified by the JMH criteria, theirZscores presented the widest variation calculated by the McCrindleet almethod. Conclusions The JMH criteria underestimate the prevalence of CAAs as compared with theZ-score criteria. Quantitative assessment of coronary artery luminal dimensions, normalized asZscores adjusted for body surface, should be recommended. The larger coronary artery luminal dimensions vary, the more heterogeneousZscores calculated by different methods have.