title: Multiplane transoesophageal echocardiographic detection of thoracic aortic plaque is a marker for coronary artery disease in women.
abstract: OBJECTIVE
  This study was conducted to examine if the multiplane transoesophageal echocardiographic detection of atherosclerotic plaque in the thoracic aorta could predict the absence or the presence and the severity of significant coronary artery disease in women. Its association with coronary disease is attractive and may have great influence on foregoing routine preoperative cardiac catheterization in patients with valvular heart disease but no data are available in women.
  
  
  METHODS
  Clinical and angiographic features and transoesophageal echocardiographic findings were prospectively analysed in 111 women.
  
  
  RESULTS
  In 24 women with significant coronary disease, 20 had thoracic aortic plaque on transoesophageal echocardiographic studies. In contrast, aortic plaque existed in only 12 of the remaining 87 women with normal or mildly abnormal coronary arteries. Therefore, the presence of aortic plaque had a sensitivity of 83%, a specificity of 86%, a positive and negative predictive values of 62% and 95%, respectively for the detection of significant coronary disease. There was a significant relation between the severity and the extent of atherosclerotic lesions and the angiographic coronary score (P<0.0001). Multivariate logistic regression analysis revealed that aortic plaque was the most significant independent marker of coronary disease (odds ratio=27.9; 95% confidence interval=5.5-131.6; P<0.0001).
  
  
  CONCLUSIONS
  This prospective study indicates that multiplane transoesophageal echocardiographic examination of thoracic atherosclerotic plaque is a marker for coronary disease in women and especially a powerful predictor of absence of significant coronary artery disease. Transoesophageal echocardiographic aortic examination might be used with risk factors and angina symptoms to discuss the need for preoperative coronary angiography in women with valvular heart disease.
authors.affiliation: Department of Cardiology, South Hospital, University of Picardie, Amiens, France.
authors.forename: C
authors.initials: C
authors.lastname: Tribouilloy
authors.forename: M
authors.initials: M
authors.lastname: Peltier
authors.forename: M
authors.initials: M
authors.lastname: Senni
authors.forename: L
authors.initials: L
authors.lastname: Colas
authors.forename: J L
authors.initials: JL
authors.lastname: Rey
authors.forename: J P
authors.initials: JP
authors.lastname: Lesbre
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000473:pathology; D015415:Biomarkers; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers