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Updated: Jul 6, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Evaluation of left main coronary artery stenosis by transthoracic echocardiography
Anne Anjaneyulu1, Krishnaswamy Raghu, Sunehra Chandramukhi
1Department of Cardiology, CARE Hospital (The Institute of Medical Sciences), Hyderabad, India. anjan_anne@yahoo.com <E-mail:anjan_anne@yahoo.com>
Insights
Transthoracic echocardiography can effectively assess left main coronary artery (LM) stenosis. This non-invasive method shows acceptable sensitivity and specificity for diagnosing LM stenosis in patients with coronary artery disease.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Transesophageal echocardiography is the primary method for evaluating left main coronary artery (LM) stenosis.
- Coronary artery disease (CAD) management requires accurate assessment of LM stenosis.
Purpose of the Study:
- To demonstrate the efficacy of transthoracic echocardiography (TTE) in assessing left main coronary artery (LM) stenosis.
- To establish TTE as a viable alternative for LM stenosis evaluation.
Main Methods:
- 1456 patients with CAD underwent TTE, with 801 having adequate coronary flow assessment.
- Color flow and Doppler evaluated LM and adjacent arteries; abnormal flow defined by mosaic flow or peak diastolic velocity ≥1.5 m/s.
- Findings correlated with coronary angiography; 40 patients with abnormal flow (Group 1) and 56 with normal flow (Control, Group 2) analyzed.
Main Results:
- Group 1 showed LM peak diastolic velocities of 1.5–4.4 m/s (mean 2.11 m/s). 85% sensitivity and 82.5% PPV for significant LM stenosis.
- Group 2 showed LM velocities of 0.4–1.2 m/s (mean 0.66 m/s). 88% specificity and 90.7% NPV for normal LM.
- Mosaic flow indicated significant LM stenosis in 85% of patients; normal flow did not exclude distal LM stenosis in 12%.
Conclusions:
- Transthoracic echocardiography provides an acceptable assessment of left main coronary artery stenosis.
- TTE demonstrates potential as a sensitive and specific tool for LM stenosis diagnosis.
Objective:
We sought to demonstrate left main coronary artery (LM) stenosis by transthoracic echocardiography.
Background:
Evaluation of LM stenosis was done mostly by transesophageal echocardiography in patients with coronary artery disease.
Methods:
A total of 1456 patients with coronary artery disease were studied, of which 801 patients (55%) had adequate coronary flow assessment. The LM and the adjacent segments of left anterior descending coronary artery and left circumflex coronary artery were evaluated by color flow and Doppler. Mosaic flow and/or peak diastolic velocity of greater than or equal to 1.5 m/s was considered abnormal. These findings were correlated with stenoses at coronary angiography. A total of 40 patients who had abnormal diastolic flow in LM by transthoracic echocardiography constituted group 1 and 56 patients with normal LM flow constituted the control group (group 2).
Results:
The peak diastolic velocities in LM in group 1 ranged between 1.5 and 4.4 m/s (mean 2.11 +/- 0.78 m/s). Of the 40 patients in group 1, 34 had significant LM stenosis by coronary angiography (sensitivity of 85%, positive predictive value 82.5%). The velocities in LM in group 2 ranged between 0.4 and 1.2 m/s (mean 0.66 +/- 0.25 m/s). In all, 49 of 56 patients in this group had normal LM on coronary angiography (88% specificity, negative predictive value 90.7%). The remaining 7 had distal LM stenosis. Mosaic flow in LM indicated significant LM stenosis in 85% of patients, whereas normal flow in LM did not rule out distal LM stenosis in 12% of patients.
Conclusions:
LM stenosis could be assessed by transthoracic echocardiography with an acceptable degree of sensitivity and specificity.
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