title: Aortic atherosclerotic lesions in the thoracic aorta detected by multiplane transesophageal echocardiography as a predictor of coronary artery disease in elderly patients.
abstract: BACKGROUND
  The presence of atherosclerotic lesions in the thoracic aorta by transesophageal echocardiography (TEE) appears to be a marker for the presence of significant coronary artery disease (CAD) in the general population.
  
  
  OBJECTIVE
  We investigated whether atherosclerotic lesions in the thoracic aorta, by multiplane TEE, could be a marker for CAD in elderly patients.
  
  
  METHODS
  In all, 127 patients (67 men, 60 women, aged 68 +/- 13 years), underwent a TEE study with imaging of the thoracic aorta and cardiac catheterization with coronary angiography. The presence of a distinct, linear, or focal, highly echogenic mass protruding into the vessel lumen was the criterion for the diagnosis of atherosclerotic plaque.
  
  
  RESULTS
  Atherosclerotic lesions were found in 30 of 36 patients (83.3%) with and in 20 of 91 (22%) without CAD. Of the 41 patients > or = 70 years, atherosclerotic lesions were detected in 14 of 17 (82.3%) with and in 13 of 24 patients (54%) without CAD. The sensitivity, specificity, and positive and negative predictive values in this group were 82.3, 46, 52, and 78.6%, respectively. Multivariate logistic regression analysis revealed that in patients aged > or = 70 years only advanced atherosclerotic lesions were independent predictors of significant CAD. However, the high negative predictive value of the method indicates that the absence of aortic plaque is a strong predictor of the absence of CAD.
  
  
  CONCLUSIONS
  The presence of atherosclerotic lesions in the thoracic aorta is a strong predictor of CAD only in patients < 70 years old. However, the negative predictive value of the method is high for all patients regardless of age.
authors.affiliation: Cardiology Department, University Hospital of Heraklion, Crete, Greece.
authors.forename: F I
authors.initials: FI
authors.lastname: Parthenakis
authors.forename: G E
authors.initials: GE
authors.lastname: Kochiadakis
authors.forename: E I
authors.initials: EI
authors.lastname: Skalidis
authors.forename: M K
authors.initials: MK
authors.lastname: Kanakaraki
authors.forename: N E
authors.initials: NE
authors.lastname: Mezilis
authors.forename: E M
authors.initials: EM
authors.lastname: Kanoupakis
authors.forename: P E
authors.initials: PE
authors.lastname: Vardas
authors.forename: P
authors.initials: P
authors.lastname: Nihoyannopoulos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging*; D001161:Arteriosclerosis / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D017548:Echocardiography, Transesophageal / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors