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Multiple aortic root echoes: clinical, radiographic, and angiographic correlations
Insights
Multiple diastolic echoes in the aortic root on echocardiography can indicate significant coronary artery disease. Further evaluation is recommended for patients without aortic stenosis or insufficiency, as this finding is linked to calcification in coronary arteries.
Area of Science:
- Cardiovascular Imaging
- Diagnostic Cardiology
- Echocardiography
Background:
- M-mode echocardiography can reveal multiple diastolic echoes in the aortic root.
- These echoes may suggest aortic wall, leaflet, or coronary artery calcification.
Purpose of the Study:
- To investigate the association between multiple diastolic echoes in the aortic root and coronary artery calcification.
- To determine the clinical significance of these echoes in patients without significant aortic valve disease.
Main Methods:
- Evaluation of 83 patients with multiple diastolic echoes using M-mode echocardiography and cardiac fluoroscopy.
- Assessment of valvular, coronary, and aortic wall calcification.
- Exclusion of patients with significant aortic stenosis or insufficiency.
Main Results:
- Multiple diastolic echoes were highly associated with significant coronary artery calcification (64% of patients).
- Over two-thirds of these patients had multivessel coronary artery disease.
- The association remained significant in patients without severe aortic stenosis or insufficiency.
Conclusions:
- Multiple diastolic echoes in the aortic root, in the absence of significant aortic valve disease, are a strong indicator of coronary artery calcification.
- Patients presenting with these echocardiographic findings warrant further investigation for significant multivessel coronary artery disease.
Abstract:
Multiple diastolic echoes in the aortic root on M-mode echocardiography may represent fibrosis or calcification of the aortic wall, aortic leaflets, or proximal portions of the coronary arteries. In this study, 83 patients with multiple diastolic echoes were evaluated by cardiac fluoroscopy and the incidence of valvular, coronary, and aortic wall calcification was determined. In patients with multiple diastolic echoes who have no evidence of significant aortic stenosis (aortic valve opening less than or equal to 1.0 cm) or aortic insufficiency (fine fluttering of the anterior leaflet of the mitral valve), the presence of multiple diastolic echoes was highly associated with significant coronary artery calcification (64%) with over two-thirds having multivessel involvement. Patients referred for echocardiography who are free of significant aortic stenosis or aortic insufficiency by echocardiographic criteria who are found to have multiple diastolic echoes in the aortic root should be evaluated further for the possible presence of significant multivessel coronary artery disease.