[Visualization of coronary artery obstructions by echocardiography]

The purpose of this study was to determine the sensitivity and specificity of 2D ECO in identifying proximal and medial obstruction of the coronary artery.

Sixty five patients with coronary artery disease were studied. In thirty three patients with previous coronary angiography the echocardiographer had knowledge of the topography and the degree of the coronary obstruction (group I) but in thirty two patients he didn't (group II). The mean age of group I was 54.4 years (44 to 76) and the mean age of the group II was 58 years (42 to 74). Two-dimensional echocardiography was performed at short-axis cross-sectional of aortic valve and images were frozen at end-diastole and reject settings were used to best visualize the coronary artery.

It was possible to observe by 2D ECO the left main coronary artery in all patients. It was also possible to identify the proximal segment of the three main arteries. The detection of obstruction was overestimated by 2D ECO when it was in the left main coronary artery. In the proximal segment, in group I, the detection of obstruction in LAD, RCA and CXA was 87.5%, 66.6% and 50% and in group II, 77.7%, 100% and 50% respectively. In the medial segment, in group I, the detection of obstruction in LAD and CXA was respectively 100% and 33.3% and in group II, 60% and 75%. These results show that the sensitivity and specificity to detect obstruction was highest in the LAD. The method overestimated the presence of obstruction in the medial segment of RCA in both groups.

These findings indicate that 2D ECO is a feasible noninvasive method in assessing obstruction of the main coronary arteries with good sensitivity and specificity.