MULTIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHIC DETECTION OF THORACIC AORTIC PLAQUE IS A MARKER FOR CORONARY-ARTERY DISEASE IN WOMEN

Objective: This study was conducted to examine if the multiplane trans oesophaegeal echocardiographic detection of atherosclerotic plaque in the thoracic aorta could predict the absence or the presence and the s everity of significant coronary artery disease in women. Its associati on with coronary disease is attractive and may have great influence on foregoing routine preoperative cardiac catheterization in patients wi th valvular heart disease but no data are available in women. Methods: Clinical and angiographic features and transoesophageal echocardiogra phic findings were prospectively analysed in 111 women. Results: In 24 women with significant coronary disease, 20 had thoracic aortic plaqu e on transoesophageal echocardiographic studies. In contrast, aortic p laque existed in only 12 of the remaining 87 women with normal or mild ly abnormal coronary arteries. Therefore, the presence of aortic plaqu e had a sensitivity of 83%, a specificity of 86%, a positive and negat ive predictive values of 62% and 95%, respectively for the detection o f significant coronary disease. There was a significant relation betwe en the severity and the extent of atherosclerotic lesions and the angi ographic coronary score (P<0.0001). Multivariate logistic regression a nalysis revealed that aortic plaque was the most significant independe nt marker of coronary disease (odds ratio=27.9; 95% confidence interva l=5.5-131.6; P<0.0001). Conclusions: This prospective study indicates that multiplane transoesophageal echocardiographic examination of thor acic atherosclerotic plaque is a marker for coronary disease in women and especially a powerful predictor of absence of significant coronary artery disease. Transoesophageal echocardiographic aortic examination might be used with risk factors and angina symptoms to discuss the ne ed for preoperative coronary angiography in women with valvular heart disease. (C) 1997 Elsevier Science Ireland Ltd.