Background : The assessment of coronary artery disease(CAD), especially left anterior descending artery (LAD), by transthoracic Doppler echocardiography(TTDE) has become popular recently. And its ability to detect the CAD has been validated. But sensitivity and specificity for detecting the CAD by TTDE varies with lesion severity. So we reviewed our data on TTDE for coronary artery according to severity of LAD lesion.
Subjects : We studied 101 subjects receiving the examinations of both TTDE for coronary artery and coronary angiography. With TTDE using the 7- and 12-MHz transducer, we examined distal LAD at modified 2-chamber view and checked the peak diastolic velocity(PDV) and time velocity integral(TVI) during diastole. According to the severity of LAD lesion in quantitative coronary angiography, we classified subjects into normal, mild(stenosis of 50-75%), moderate(76-90%), and severe(more than 90%) group.
Results : Of 101 patients, 45 subjects belonged to normal group and 56 subjects to patient group(mild; 22, moderate; 18, severe; 16). PDV of normal group was 30.2±9.5 cm/s. As we compared the normal group with patient group that had stenosis of more than 50%, there was no statistic significance in PDV or TVI, although the patient group had lower PDV. When we compared with patient group that had stenosis of more than 75%, there was also no statistic significance. But compare with severe stenosis group, we found that severe stenosis group had lower PDV and TVI (24.7±4.5 vs 30.2±9.5 cm/s, p<0.05, 0.09±0.03 vs 0.15±0.04, p<0.05, respectively)
Conclusion : TTDE for assessment of CAD is useful tool, but our data shows that its ability to detect the LAD lesion varies with severity of CAD
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