Morganroth J, Chen C C, David D, Naito M, Mardelli T J
Am J Cardiol. 1980 Dec 18;46(7):1178-87. doi: 10.1016/0002-9149(80)90288-x.
M mode and cross-sectional echocardiographic studies at rest have been used to detect regional left ventricular wall motion abnormalities as a sign of hemodynamically significant coronary artery disease. These techniques have proved to be fairly specific but not highly sensitive. Detection of new regional wall motion abnormalities with cross-sectional echocardiography during exercise appeared practical in 80 percent of patients in preliminary studies; the finding of such abnormalities is highly specific for the presence of coronary artery disease and, with this approach, the sensitivity of echocardiography is improved. Thus, patients with anatomically severe coronary artery disease on angiography may not manifest an echocardiographic abnormality in regional wall motion even during exercise. The direct noninvasive detection of the left main coronary artery in up to 90 percent of patients studied with cross-sectional echocardiography using the short axis or apical approach, or both, has been well defined. A high sensitivity and specificity of detecting anatomically severe left main coronary artery disease using the criteria of both luminal impingement and the presence of high intensity echoes have been confirmed. Further advances in imaging techniques may allow for better definition of the coronary arterial tree.
静息状态下的M型和横截面超声心动图研究已被用于检测局部左心室壁运动异常，作为血流动力学显著的冠状动脉疾病的标志。这些技术已被证明具有相当高的特异性，但敏感性不高。在初步研究中，80%的患者通过运动期间的横截面超声心动图检测新的局部壁运动异常似乎是可行的；发现此类异常对冠状动脉疾病的存在具有高度特异性，采用这种方法可提高超声心动图的敏感性。因此，即使在运动期间，血管造影显示解剖学上严重冠状动脉疾病的患者在局部壁运动中可能也不会表现出超声心动图异常。使用短轴或心尖方法（或两者）进行横截面超声心动图研究的患者中，高达90%的患者可直接无创检测左主冠状动脉，这一点已得到明确。使用管腔压迫和高强度回声存在的标准检测解剖学上严重的左主冠状动脉疾病已被证实具有高敏感性和特异性。成像技术的进一步进展可能有助于更好地描绘冠状动脉树。
