No abstract

SUMMARY Esophageal echocardiography was developed for recording left ventricular anterolateral wall (LVAW) echocardiograms and was applied clinically to 14 normal subjects and 21 patients with coronary artery disease. LVAW echocardiograms were obtained satisfactorily in 11 of 14 normal subjects (75%) and 20 of 21 patients (95%) with coronary artery disease. LVAW echocardiograms were obtained by conventional anterior echocardiography in eight of 21 patients (38%) with coronary artery disease. In 11 normal subjects, LVAW excursion averaged 10.8 ± 1.7 mm (range 8-13 mm); mean systolic velocity ranged from 28-41 mm/sec (mean 34.3 ± 5.2 mm/sec); and diastolic wall thickness ranged from 9-12.5 mm (mean 11.2 + 0.7 mm). In 20 patients with coronary artery disease, LVAW motion obtained by esophageal echocardiography was classified into five groups according to the excursion, and the findings were in good agreement (80%) with those obtained by left ventriculography. Classification of LVAW motion by conventional echocardiography agreed with that of left ventriculography in only three of eight patients, although all eight patients had abnormal LVAW motion by the conventional method. In all patients except one, whose LVAW echocardiograms were obtained by conventional echocardiography, excursion was much less than that obtained by esophageal echocardiography. We conclude that the projection of an ultrasonic beam from the intraesophageal transducer is a better approach for accurate measurement of LVAW motion.ABNORMAL left ventricular wall motion occurs in some patients with severe coronary artery disease. The left ventricular anterior wall (LVAW) and interventricular septum (IVS) are supplied by the left anterior descending coronary artery (LAD), and generally, motion of those walls is impaired if severe stenosis of this artery causes ischemia.Echocardiography is one of the most useful noninvasive procedures for evaluating left ventricular regional wall motion.'-8 In patients with severe obstruction of the LAD, abnormal IVS motion may be seen by "conventional echocardiography" by placing the transducer along the left sternal border.