Diagnostic value of coronary artery assessment by transthoracic ecocardiography

Abstract

Funding Acknowledgements Type of funding sources: None. Several recent studies have reported the opportunity for diagnosing significant narrowing of the coronary arteries during echocardiography using the local flow acceleration in the stenosis. However, there is a discrepancy between the cut-off coronary flow velocity (CFV) values in the literature. The aim of our study was to define the cut-off value of CFV for coronary artery stenosis more than 50%. Methods In a single-center study, we evaluated 100 patients (53 men, 62 ± 11 y.o.) who underwent echocardiography with scans for CFV in 3 segments of left coronary artery. Coronary angiography was performed by an independent expert specialist, blind other data. Results Two hundred and fifty-three segments (84%) of proximal left coronary were feasible for assessment. There was a significant correlation between coronary flow velocity and percent of stenosis in the corresponding segments, R = 0.52; p < 0.0000001, (figure). The cut-off value of 67 cm/s had sensitivity 69%, specificity 89%, accuracy 79%, р<0.0004 for left main narrowing more than 50% by angiography. The cut-off value of 70 cm/s in proximal segment of left anterior descending had sensitivity 62%, specificity 88%, accuracy 82%, р<0.0001, the cut-off value of 50 cm/s in proximal segment of left circumflex had sensitivity 73%, specificity 88%, accuracy 81%, р<0.003 for stenoses of more than 50%. Conclusion There is a significant positive correlation between coronary flow velocity by echocardiography and degree of narrowing by angiography.