Detection of subclinical coronary atherosclerosis using two-dimensional, high-resolution transthoracic echocardiography

J Am Coll Cardiol. 2001 Apr;37(5):1422-9. doi: 10.1016/s0735-1097(01)01160-3.


Objectives: We evaluated whether two-dimensional high-resolution transthoracic echocardiography (HR-2DTTE) can detect changes in arterial wall thickness and size associated with subclinical coronary artery disease (CAD).

Background: Arterial wall thickening, compensatory arterial enlargement and a preserved arterial lumen characterize subclinical atherosclerosis. Detection of these changes during the asymptomatic stage of CAD may allow early treatment and prevention of acute coronary events.

Methods: Twenty-six patients with angiographically proven CAD and 29 normal volunteers underwent HR-2DTTE evaluation of the left anterior descending coronary artery (LAD) using an ATL 5000 echograph (Advanced Technology Laboratories, Bothell, Washington) with a 4 to 7 MHz transducer. Significant (>70%) LAD stenosis was present in 15 patients (mean 82%); 11 patients did not have significant LAD stenosis (mean 26%) and represented a surrogate for subclinical LAD disease. Wall thickness, maximal luminal diameter and external diameter of the LAD were measured.

Results: Left anterior descending coronary artery wall thickness was larger in patients (1.9 +/- 0.4 mm) than it was in volunteers (0.9 +/- 0.1 mm, p < 0.001). The external diameter of the LAD was (6.0 +/- 1.1 mm) in patients and (3.9 +/- 0.7 mm) in volunteers (p < 0.001). Luminal diameter was 2.2 +/- 0.5 mm in patients and 2.1 +/- 0.6 mm in volunteers (p = NS). There was no difference in wall thickness (1.9 +/- 0.4 mm vs. 2.0 +/- 0.4 mm), luminal diameter (2.2 +/- 0.5 mm vs. 2.2 +/- 0.4 mm) and external diameter (5.9 +/- 1.0 mm vs. 6.2 +/- 1.2 mm) between the patients with <70% and >70% LAD stenosis.

Conclusions: Left anterior descending coronary artery wall thickness and external diameter are significantly increased in patients with CAD as compared with normal subjects, and HR-2DTTE is sensitive enough to detect these differences. Wall thickness and external diameter are increased to the same extent in patients with obstructive and subclinical LAD disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Vessels / diagnostic imaging
  • Echocardiography*
  • Female
  • Humans
  • Image Enhancement*
  • Male
  • Middle Aged
  • Sensitivity and Specificity