[Prediction of the location of left anterior descending coronary artery disease by anterior echocardiography and esophageal echocardiography (author's transl)].

In 11 normal subjects and 30 patients (pts) with left anterior descending coronary artery (LAD) lesion, the left ventricular anterolateral wall (LVAW) was investigated by esophageal echocardiography (Eso Echo) and the interventricular septum (IVS) by conventional anterior echocardiography (Ant Echo). The location of LAD obstruction, either proximal (20 pts; P-group) or distal (10 pts; D-group) to the first septal branch, was confirmed by coronary arteriography. Twenty-two of the 30 pts with LAD lesion had anteroseptal myocardial infarction (ASMI) and the remaining 8 had angina pectoris. Of the 30 pts, 20 pts including 13 pts with ASMI had normal systolic excursion of IVS. On the other hand, LVAW excursion was below 8 mm in 28 of the 30 pts with LAD lesion compared to the value of the normal subjects (10.8 +/- 1.7 mm; range = 8--13 mm). The sum of the values of IVS and LVAW excursions in the pts with ASMI was significantly lower in the P-group than those in the D-group (p less than 0.001). In the P-group, the beginning of both systolic IVS and LVAW excursion delayed significantly (IVS: 118 +/- 47 msec, LVAW: 121 +/- 44 msec from Q wave on ECG) than those of normal subjects, while in the D-group only LVAW excursion was delayed (142 +/- 23 msec) compared to that of IVS (84 +/- 32 msec). Thus, the analysis of the motion of IVS and LVAW obtained by Ant Echo and Eso Echo is useful in predicting the presence of absence as well as the location of LAD lesion.