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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
Changes in left anterior descending coronary artery wall thickness detected by high resolution transthoracic
Rebecca Perry1, Carmine G De Pasquale, Derek P Chew
1Cardiac Services, Flinders Medical Centre/Flinders University, Bedford Park, South Australia, Australia. rebecca.perry@fmc.sa.gov.au <rebecca.perry@fmc.sa.gov.au>
Insights
High-resolution transthoracic echocardiography (HRTTE) reveals thicker left anterior descending coronary artery (LAD) walls in coronary artery disease (CAD) patients. This non-invasive technique detects positive remodeling, often missed by coronary angiography.
Area of Science:
- Cardiovascular Imaging
- Diagnostic Echocardiography
- Coronary Artery Disease Research
Background:
- High-resolution transthoracic echocardiography (HRTTE) has shown potential in differentiating coronary artery disease (CAD) patients from healthy individuals based on left anterior descending (LAD) coronary artery wall thickness.
- Further validation of HRTTE's capability in assessing LAD morphology in CAD is warranted.
Purpose of the Study:
- To validate the use of HRTTE in detecting differences in LAD wall thickness and diameter between patients with angiographically proven CAD and control subjects.
- To assess if HRTTE can identify positive remodeling in the LAD of CAD patients.
Main Methods:
- One hundred ten volunteers, including 58 patients with confirmed CAD and 52 controls, underwent HRTTE for LAD assessment.
- Measurements included anterior and posterior wall thicknesses, external LAD diameter, and luminal diameter.
Main Results:
- CAD patients exhibited significantly greater anterior (1.9 vs 1.2 mm) and posterior (1.8 vs 1.2 mm) LAD wall thicknesses compared to controls (p <0.001).
- External LAD diameter was also significantly larger in the CAD group (5.2 vs 4.4 mm, p = 0.01).
- No significant difference in luminal diameter was observed between groups (p = 0.3), suggesting positive remodeling in CAD patients.
Conclusions:
- HRTTE effectively demonstrates increased LAD wall thickness and external diameter in patients with CAD.
- The findings indicate positive remodeling in the LAD of CAD patients, a change potentially undetectable by coronary angiography.
Abstract:
Recently, it has been demonstrated that high-resolution transthoracic echocardiography (HRTTE) is able to detect differences in the wall thickness of the left anterior descending coronary artery (LAD) between patients with coronary artery disease (CAD) and normal volunteers. The aim of this study was to further validate this technique. One hundred ten volunteers, 58 patients with angiographically proved CAD and 52 control subjects, underwent assessments of their LADs using HRTTE. Anterior and posterior wall thicknesses differed between subjects in the CAD group and controls (1.9 +/- 0.6 vs 1.2 +/- 0.3 mm, p <0.001, and 1.8 +/- 0.5 vs 1.2 +/- 0.3 mm, p <0.001, respectively). External LAD diameter was also greater in subjects in the CAD group compared with controls (5.2 +/- 1.9 vs 4.4 +/- 0.9 mm, respectively, p = 0.01). However, there was no difference in luminal diameter between subjects in the CAD group and the controls (1.9 +/- 0.9 vs 2.1 +/- 0.8 mm, respectively, p = 0.3). In conclusion, HRTTE demonstrated that LAD wall thicknesses and external diameters in patients with CAD were significantly larger than in normal volunteers. Luminal diameter, however, was maintained in the 2 groups, indicating that subjects in the CAD group had undergone positive remodeling at the site measured. This objectively visualized evidence of coronary atherosclerosis with HRTTE would likely be undetected during coronary angiography.
