Transthoracic echocardiography study of the left anterior descending coronary artery with a high frequency transducer

Introduction and objectives. This study was performed to evaluate the feasi bility and utility of a transthoracic high frequency transducer to detect a nd measure the left anterior descending coronary artery flow in patients wi th lesions in this artery or anterior myocardial infarction. Material and methods. We studied 11 subjects with lesions greater than 75% and another 10 with anterior myocardial infarction. We compared the results with a control group of 18 subjects. An ATL HDI 5000 ultrasound unit with a 5-8 MHz transducer was used to identify the left anterior descending in t he anterior interventricular sulcus from an apical four chamber window. We considered that left anterior descending was detected when a diastolic pred ominant flow pattern was obtained with pulse Doppler. Results. Left anterior descending was detected in 37/39 of cases (94.4%). P atients with coronary lesions showed a decrease in the limit of significanc e in the diastolic/systolic peak velocity ratios: 2.5 (SD 0.7) vs 1.8 (SD 0 .3) with a p = 0.024. Patients with anterior myocardial infarction obtained lower diastolic/systolic peak velocity ratios than controls: 2.5 (SD 0.7) vs 1.4 (SD 0.3) with a p = 0.001. Conclusions. Left anterior descending coronary artery flow can be assessed by transthoracic high frequency echocardiography in greater than 90% of the cases. Patients with coronary lesions and those with anterior myocardial i nfarction have a decreased diastolic/systolic peak velocity ratio.