Comparison of usefulness of the wall thickness of the left anterior descending coronary artery, determined by transthoracic echocardiography, and carotid intima-media thickness in predicting multivessel coronary artery disease.
BACKGROUND
Wall thickness in the distal part of the left anterior descending coronary artery (LAD) can be measured by using two-dimensional high-resolution transthoracic echocardiography (2DHTTE). The objective of this study was to compare the diagnostic accuracy of measuring carotid intima-media thickness (IMT) and distal LAD wall thickness for prediction of multivessel coronary artery disease (MVD).


METHODS
We measured wall thickness in the distal LAD using 2DHTTE and carotid IMT using B-mode ultrasound in 100 patients who subsequently underwent coronary angiography (CAG). Patients were classified into three groups based on the results of CAG-no significant stenosis (group N), single-vessel disease (group S), or multivessel disease (group M).


RESULTS
Successful measurements of LAD wall thickness were accomplished in 96 patients. Distal LAD wall thickness was significantly greater in group M (0.92 ± 0.20 mm) than in group N (0.72 ± 0.11 mm, P < 0.01) and group S (0.76 ± 0.19 mm, P < 0.01). Carotid IMT was significantly greater in group M (0.90 ± 0.24 mm) than in group N (0.75 ± 0.21 mm, P < 0.05) and group S (0.80 ± 0.17 mm, P < 0.05). Distal LAD wall thickness >0.8 mm had a sensitivity of 75% and a specificity of 67% in predicting MVD, whereas carotid IMT >0.8 mm was 63% sensitive and 67% specific in the prediction of MVD. There was a weak but significant correlation between distal LAD wall thickness and IMT (r = 0.31, P < 0.01).


CONCLUSIONS
Non-invasive measurement of distal LAD wall thickness by 2DHTTE is feasible, and has equivalent diagnostic accuracy to IMT measurements for predicting MVD.
Second Department of Internal Medicine, University of Occupational and Environmental Health, 1-1 Isegaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
Hidetoshi
H
Yoshitani
Second Department of Internal Medicine, University of Occupational and Environmental Health, 1-1 Isegaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan. masaaki_takeuchi@hotmail.com.
Masaaki
M
Takeuchi
Department of Internal Medicine and Cardiology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Keitaro
K
Ogawa
Second Department of Internal Medicine, University of Occupational and Environmental Health, 1-1 Isegaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
Yutaka
Y
Otsuji
Angina pectoris; Carotid intima-media thickness; Coronary artery; Two-dimensional echocardiography