Prospective evaluation of the left main coronary artery using digital two-dimensional echocardiography

Thomas Ryan, William F. Armstrong, Harvey Feigenbaum

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Recent clinical studies emphasizes the importance of identification of patients with left main coronary artery obstruction. Although two-dimensional echocardiography can detect left main coronary artery disease, the technique requires frame by frame analysis, as no single frame provides all the necessary information. To determine if newly available computed-based digital processing techniques could overcome some of these technical difficulties, 119 consecutive patients were prospectively evaluated with two-dimensional echocardiography before coronary angiography. A continuous loop recording of the left main coronary artery was recorded as it passed through the ultrasonic beam in the short-axis view. Starting at a point when the vessel was first visualized, the ensuing eight consecutive fields, each 17 ms apart, were captured in digital format, thus providing a series of parallel, sequential, longitudinal slices of the left main coronary artery as it traversed the imaging plane. This was succesfully accomplished in 100 (84%) of the 119 consecutive patients. By angiography, 16 patients (16%) had greater than 50% narrowing of the left main coronary artery. Digital echocardiography correctly identified 15 of these 16 patients (94% sensitivity) and accurately localized the lesion in 12 (80%) of 15. Of 84 patients without significant left main coronary artery obstruction, digital echocardiography correctly identified 78 (93% specificity). It was concluded that computer-based digital processing techniques can be applied to two-dimensional echocardiography to allow reliable visualization of the left main coronary artery. The technique provides more information than a single still frame and allows accurate noninvasive detection and possible localization of left main coronary artery lesions.

Original languageEnglish (US)
Pages (from-to)807-812
Number of pages6
JournalJournal of the American College of Cardiology
Issue number4
StatePublished - 1986

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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