title: High echogenic thickening of proximal coronary artery predicts the far advanced coronary atherosclerosis.
abstract: BACKGROUND
  Detection of subclinical, nonobstructive coronary artery disease will require the evaluation of coronary arterial walls and external coronary diameter in order to detect increases in arterial wall thickness and compensatory remodeling before luminal narrowing. We assessed the meaning of high echogenic thickening (HET) on transthoracic coronary echogram of proximal coronary arteries and evaluated whether HET predicts the severity of coronary artery disease on angiogram.
  
  
  METHODS
  Ninety-seven patients (M:F = 61:36, mean age = 61+/-8 years) referred for coronary angiography were included in this study. We detected proximal coronary artery using transthoracic coronary echogram. We defined that HET is more than 1.5 mm in thickness with high echogenicity and persistence. Of these patients, 29 vessels were examined by IVUS (intravascular ultrasound).
  
  
  RESULTS
  (1) HET on coronary echogram had a sensitivity of 44.4% and specificity of 95% for identifying calcification on IVUS. (2) HET had a sensitivity of 73.5% and specificity of 85.7% for identifying the significant stenosis of proximal left coronary artery. (3) HET was observed more frequently in three-vessel diseases and more complex lesion compared to normal and one- or two-vessel diseases (P < 0.05, respectively).
  
  
  CONCLUSIONS
  HET may be related to the presence of calcification and predicts far advanced coronary atherosclerosis.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yun-Seok
authors.initials: YS
authors.lastname: Choi
authors.forename: Ho-Joong
authors.initials: HJ
authors.lastname: Youn
authors.forename: Chul-Soo
authors.initials: CS
authors.lastname: Park
authors.forename: Yong-Seog
authors.initials: YS
authors.lastname: Oh
authors.forename: Wook-Sung
authors.initials: WS
authors.lastname: Chung
authors.forename: Jae-Hyung
authors.initials: JH
authors.lastname: Kim
mesh_terms: D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018084:Ultrasonography, Interventional / Q000379:methods