Detection and quantification of left main coronary artery stenosis by two-dimensional echocardiography

This study was undertaken to determine the diagnostic feasibility of detecting both qualitatively and quantitatively stenotic wall abnormalities in the left main coronary artery (LMCA) and its bifurcation. Adequate two-dimensional echocardiographic (2DE) images of the LMCA were obtained in 18 of 20 patients with angiographically proven coronary artery disease (CAD). In 15 of 18 patients the LMCA was completely imaged but in different 2DE-planes in most of the cases. Only in 4 of 18 patients could adequate images of the bifurcation, including the central parts of left anterior descending and circumflex branches, be demonstrated. On the contrary, the 2DE detected calcification of the LMCA identified by fluoroscopy in only 2 of 5 patients. As to quantitative analysis, the correlation of luminal diameters in stenotic and non-stenotic coronary artery obtained from 2DE and coronary angiography was satisfactory (r = 0.69, p less than 0.01). These results suggest that 2DE can be useful for the follow-up study of LMCA disease. However, this method is not indicated for the detection of more distal left coronary artery stenosis occurring beyond the bifurcation.