Vegsundvåg Johnny, Holte Espen, Wiseth Rune, Hegbom Knut, Hole Torstein
Department of Internal Medicine, Alesund Hospital, Alesund, Norway.
Cardiovasc Ultrasound. 2009 Dec 22;7:58. doi: 10.1186/1476-7120-7-58.
Transthoracic echocardiography (TTE) may be used for direct inspection of various parts of the main coronary arteries for detection of coronary stenoses and occlusions. We aimed to assess the feasibility of TTE to visualise the complete segments of the left main (LM), left descending (LAD), circumflex (Cx) and right (RCA) coronary arteries.
One hundred and eleven patients scheduled for diagnostic coronary angiography because of chest pain or acute coronary syndrome had a TTE study to map the passage of the main coronary arteries. LAD, Cx and RCA were each divided into proximal, middle and distal segments. If any part of the individual segment of a coronary artery with antegrade blood flow was not visualised, the segment was labeled as not satisfactorily seen.
Complete imaging of the LM was achieved in 98% of the patients. With antegrade directed coronary artery flow, the proximal, middle and distal segments of LAD were completely seen in 96%, 95% and 91% of patients, respectively. Adding the completely seen segments with antegrade coronary flow and segments with retrograde coronary flow, the proximal, middle and distal segments of LAD were adequately visualised in 96%, 96% and 93% of patients, respectively. With antegrade directed coronary artery flow, the proximal, middle and distal segments of Cx were completely seen in 88%, 61% and 3% and in RCA in 40%, 28% and 54% of patients. Retrograde coronary artery flow was correctly identified as verified by coronary angiography in seven coronary segments, mainly in the posterior descending artery (labeled as the distal segment of RCA) and distal LAD.
TTE is a feasible method for complete demonstration of coronary flow in the LM, the proximal Cx and the different segments of LAD, but less suitable for the RCA and mid and distal segments of the Cx. (ClinicalTrials.gov number NTC00281346.).
经胸超声心动图（TTE）可用于直接检查主要冠状动脉的各个部分，以检测冠状动脉狭窄和闭塞情况。我们旨在评估TTE对左主干（LM）、左前降支（LAD）、回旋支（Cx）和右冠状动脉（RCA）完整节段进行成像的可行性。
111例因胸痛或急性冠状动脉综合征而计划进行诊断性冠状动脉造影的患者接受了TTE检查，以描绘主要冠状动脉的走行。LAD、Cx和RCA均分为近端、中段和远端节段。如果冠状动脉某单个节段有正向血流但其中任何部分未被显示，则该节段标记为显示不满意。
98%的患者实现了LM的完整成像。在冠状动脉正向血流情况下，LAD近端、中段和远端节段分别在96%、95%和91%的患者中被完整显示。将有正向冠状动脉血流的完整显示节段与有逆向冠状动脉血流的节段相加，LAD近端、中段和远端节段分别在96%（近端）、96%（中段）和93%（远端）的患者中得到充分显示。在冠状动脉正向血流情况下，Cx近端、中段和远端节段分别在88%、61%和3%的患者中被完整显示，RCA在40%（近端）、28%（中段）和54%（远端）的患者中被完整显示。经冠状动脉造影证实，在7个冠状动脉节段正确识别出逆向冠状动脉血流，主要在右冠状动脉后降支（标记为RCA远端节段）和LAD远端。
TTE是一种可行的方法，可完整显示LM、Cx近端以及LAD不同节段的冠状动脉血流，但不太适用于RCA以及Cx的中段和远端节段。（ClinicalTrials.gov编号：NTC00281346。）
