Three dimensionally acquired, two dimensionally displayed transthoracic echocardiographic detection of coronary artery disease

William C. Maxled, Susan T. Swansea, Melinda Huntley, Stephen Sawada, Douglas S. Segar, Harvey Feigenbaum

Research output: Contribution to journalArticle

Abstract

The diagnosis of subclinical CAD has become increasingly important as therapy may prevent a first clinical event, which can be disastrous. Electron beam CT has shown potential in diagnosing subclinical CAD, but its effectiveness is limited in young patients whose arteries may not be calcified. Our laboratory has demonstrated that three dimensionally acquired, two dimensionally displayed transthoracic echocardiography (3D/2D TIE) can reliably interrogate the left main (LM) and left anterior descending (LAD) coronary arteries. We hypothesize that angiographically diseased coronary arteries in young patients appear different echocardiographically man angiographically normal coronary arteries. Methods: 3D/2D TTE was performed on 21 patients under the age of 50 who had undergone coronary arteriography within four months. One patient was technically unsatisfactory. Attempts at recording the LM and proximal, mid, and distal LAD were made in the remaining 20 patients. The width of the entire vessel, each wall and the lumen was measured in all segments visualized. Measurements were taken separately by two independent reviewers. Results: The frequencies with which the individual segments were seen were: LM 19/20 or 95%, proximal LAD 15/20 or 75%, mid LAD 18/20 or 90%, and distal LAD 18/20 or 90%. All segments were seen in 13/20 or 65% of patients. Only one patient with angiographically normal coronaries had a wall segment thicker man 1.5 mm. hi patients with angiographic CAD 11/12 or 92% had vessel walls thicker than 1.5 mm in the LM or some segment of the LAD regardless of the angiographic location of disease, consistent with the diffuse nature of CAD. Conclusion: In this small group of patients under the age of 50, finding a wall segment of the LM or LAD thicker than 1.5 mm had a sensitivity of 92% and a specificity of 88% in detecting CAD. 3D/2D TTE may be a practical noninvasive technique in detecting preclinical CAD, especially in patients under 50 years old.

Original languageEnglish
Pages (from-to)412
Number of pages1
JournalJournal of the American Society of Echocardiography
Volume10
Issue number4
StatePublished - 1997

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Coronary Artery Disease
Coronary Vessels
Echocardiography
Angiography
Arteries
Electrons

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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Three dimensionally acquired, two dimensionally displayed transthoracic echocardiographic detection of coronary artery disease. / Maxled, William C.; Swansea, Susan T.; Huntley, Melinda; Sawada, Stephen; Segar, Douglas S.; Feigenbaum, Harvey.

In: Journal of the American Society of Echocardiography, Vol. 10, No. 4, 1997, p. 412.

Research output: Contribution to journalArticle

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abstract = "The diagnosis of subclinical CAD has become increasingly important as therapy may prevent a first clinical event, which can be disastrous. Electron beam CT has shown potential in diagnosing subclinical CAD, but its effectiveness is limited in young patients whose arteries may not be calcified. Our laboratory has demonstrated that three dimensionally acquired, two dimensionally displayed transthoracic echocardiography (3D/2D TIE) can reliably interrogate the left main (LM) and left anterior descending (LAD) coronary arteries. We hypothesize that angiographically diseased coronary arteries in young patients appear different echocardiographically man angiographically normal coronary arteries. Methods: 3D/2D TTE was performed on 21 patients under the age of 50 who had undergone coronary arteriography within four months. One patient was technically unsatisfactory. Attempts at recording the LM and proximal, mid, and distal LAD were made in the remaining 20 patients. The width of the entire vessel, each wall and the lumen was measured in all segments visualized. Measurements were taken separately by two independent reviewers. Results: The frequencies with which the individual segments were seen were: LM 19/20 or 95{\%}, proximal LAD 15/20 or 75{\%}, mid LAD 18/20 or 90{\%}, and distal LAD 18/20 or 90{\%}. All segments were seen in 13/20 or 65{\%} of patients. Only one patient with angiographically normal coronaries had a wall segment thicker man 1.5 mm. hi patients with angiographic CAD 11/12 or 92{\%} had vessel walls thicker than 1.5 mm in the LM or some segment of the LAD regardless of the angiographic location of disease, consistent with the diffuse nature of CAD. Conclusion: In this small group of patients under the age of 50, finding a wall segment of the LM or LAD thicker than 1.5 mm had a sensitivity of 92{\%} and a specificity of 88{\%} in detecting CAD. 3D/2D TTE may be a practical noninvasive technique in detecting preclinical CAD, especially in patients under 50 years old.",
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