Document Detail


What have we learned about coronary artery disease from high-frequency epicardial echocardiography?
MedLine Citation:
PMID:  2671168     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We have used a high frequency epicardial echocardiographic technique to visualize and measure coronary artery lumens and walls in patients undergoing cardiac surgery. A 12 MHz probe (Surgiscan, Biosound Corp.) is sterilized and placed on the exposed epicardial coronary arteries. Transverse cross-sectional views are obtained from the arteries on the anterior surface of the heart: the right coronary artery to the cardiac margin and the left anterior descending coronary artery to the cardiac apex. Numerous echocardiographic-angiographic-pathological correlations have been obtained from this work. We have validated the echocardiographic lumen and wall measurements by comparing the echo measurements to histological material from pressure-distended coronary arterial segments (from animals and fresh human autopsy specimens). We have shown by comparison with angiography that coronary arteries which appear normal or only minimally diseased by angiograms are often diffusely and severely atherosclerotic. We have also evaluated the shape of atherosclerotic lesions and demonstrated a wide range of lumen shapes (oval, circular, complex) and location within the residual coronary lumen (eccentric vs. concentric). Highly eccentric lesions are characterized by relative preservation of portions of the arterial wall, and this may preserve vasoreactivity of the atherosclerotic vessel. We have also demonstrated remodeling of atherosclerotic lesions: enlargement of the total arterial area (wall plus lumen) as a compensatory mechanism to preserve the arterial lumen in the face of encroaching atherosclerosis. High frequency epicardial echocardiography offers an accurate, real-time, in-vivo method for the anatomic and functional evaluation of coronary atherosclerosis. This dynamic, in-vivo technique supports and extends information previously obtainable only from pathologic studies.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
R E Kerber; D D McPherson; S J Sirna; A Ross; M L Marcus
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  International journal of cardiac imaging     Volume:  4     ISSN:  0167-9899     ISO Abbreviation:  Int J Card Imaging     Publication Date:  1989  
Date Detail:
Created Date:  1989-10-03     Completed Date:  1989-10-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8600426     Medline TA:  Int J Card Imaging     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  169-76     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, University of Iowa College of Medicine, Iowa City.
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MeSH Terms
Descriptor/Qualifier:
Blood Flow Velocity
Computer Simulation
Coronary Artery Disease / diagnosis*
Coronary Vessels / pathology
Echocardiography / instrumentation*
Echocardiography, Doppler / instrumentation*
Humans
Image Interpretation, Computer-Assisted / instrumentation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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