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[Correlation between aortic atherosclerosis at transesophageal echocardiography and coronary atherosclerosis]
1Service de cardiologie, l'hôpital Habib Thameur, 8, rue Ali Ben Ayed, Montfleury 1 008, Tunis, Tunisie.
Insights
Transesophageal echocardiography detection of thoracic aortic plaques is a strong predictor of coronary artery disease. This non-invasive imaging method shows high sensitivity and specificity for identifying significant coronary artery disease.
Area of Science:
- Cardiovascular Medicine
- Diagnostic Imaging
- Atherosclerosis Research
Background:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- Early detection and risk stratification are crucial for managing CAD.
- Transesophageal echocardiography (TEE) offers detailed imaging of the thoracic aorta.
Purpose of the Study:
- To evaluate the association between atherosclerotic plaques in the thoracic aorta visualized by TEE and the presence of coronary artery disease (CAD) confirmed by coronary angiography.
- To determine the diagnostic performance of detecting aortic plaques for predicting obstructive CAD.
Main Methods:
- A prospective study involving 103 patients scheduled for coronary angiography.
- All participants underwent TEE for thoracic aorta imaging.
- Aortic intimal changes and atheroma plaques were classified into 4 grades.
Main Results:
- Detection of aortic atheroma plaques was the strongest predictor of CAD.
- TEE identification of aortic plaques demonstrated 97.6% sensitivity and 80% specificity for obstructive CAD.
- Positive and negative predictive values for aortic plaques were 95.3% and 88.9%, respectively.
- Plaques in the descending aorta showed higher sensitivity, while ascending aorta plaques had higher specificity.
- Sensitivity increased with older age and in women, whereas specificity decreased in these groups.
Conclusions:
- Transesophageal echocardiography assessment of thoracic aortic plaques is a highly sensitive and specific non-invasive marker for detecting coronary artery disease.
- The presence of aortic plaques, particularly in the descending aorta, strongly predicts obstructive CAD.
- TEE imaging of aortic atheroma can aid in risk stratification for patients with suspected or known CAD.
Abstract:
The aim of this study was to test the relationship between atherosclerotic plaques in the thoracic aorta detected by transesophageal echocardiography and coronary artery disease detected by angiography. A prospective study was carried out in 103 patients who underwent coronary angiography. All patients underwent transesophageal echocardiography with imaging of the thoracic aorta. Aortic intimal changes were classified in 4 grades. The detection of aortic atheroma plaques was the strongest predictor of coronary artery disease. The presence of aortic plaques on transesophageal study had a sensitivity of 97.6% and a specificity of 80% for angiographically proved obstructive coronary artery disease. The positive predictive value of aortic plaque for obstructive coronary artery disease was 95.3% and the negative predictive value was 88.9%. Compared to the other segments, the detection of atherosclerotic plaque in the descending aorta has the highest sensitivity but the specificity was the highest in the ascending aorta. With older age and in women the specificity decreased, while the sensitivity increased.