Transthoracic Echocardiography in the Assessment of Main Coronary Arteries: Methodological Aspects, Potentials, and Limitations
The methodological aspects, potentials, and limitations of transthoracic echocardiography (TTE) without contrast enhancement in the assessment of main coronary arteries (MCA) were established in 81 coronary heart disease (CHD) patients who underwent coronary angiography within 1 week after TTE and in 19 healthy volunteers without risk CHD factors. We searched for the left main coronary artery (LMCA), proximal (p), mid (m) and distal (d) segments of the left anterior descending artery (LAD), the circumflex artery (Cx), and the right coronary artery (RCA). It was determined that TTE is an adequate method for assessment of the LMCA, all LAD segments, and dRCA. It was established that the quality of color Doppler mapping and the frequency of good Doppler velocity pattern detection does not depend on the body build for the LAD and RCA. For the first time, coronary blood flow parameters in healthy volunteers without risk CHD factors were determined. It was detected that normal coronary blood flow parameters are comparable in all three arteries - LAD, Cx and RCA, and do not change from proximal to distal segments. In addition, the LAD may be a model for the coronary blood flow assessment in persons without coronary artery stenosis as this vessel demonstrates a good Doppler flow patterns in all three (proximal, mid and distal) segments. It was established that TTE is a highly specific noninvasive method for identification of MCA stenosis >50%, which may be mainly recommended for the diagnosis of LMCA and LAD stenosis.