Evaluating Basic Two-dimensional Echocardiography for Screening in Coronary Artery Disease

Background
Basic two-dimensional echocardiography (2D-echocardiography)screens for suspected coronary artery disease (CAD) by detecting impaired left ventricular function (LVF) which declines as atherosclerosis worsens.
Aim
To evaluate basic 2D-echocardiography for CAD screening.
Methods
CAD screening was performed with 2D-echocardiography. For global screening, left ventricular ejection fraction percentage (LVEF%) was determined and categorised into global systolic LVF. For regional screening, global average echocardiography score (GAES) was quantified, then categorised into functional impairment. After screening, high-risk patients
underwent diagnostic coronary angiography. Abnormal angiography had50% luminal stenosis. Angiography was also quantified with Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score, then categorised. Statistical Package for Social Science 25.0 analysed data.
Results
There were 471 patients screened for CAD; 154/471 (33%) underwent angiography. For angiography selection amongst 471 screened patients, GAES was higher (p< 0.001) and positively correlated (Pearson’s coefficient 0.296); LVEF% was lower (p = 0.002) and negatively correlated (Pearson’s coefficient -0.187). Amongst 154 patients, SYNTAX score correlated negatively with LVEF% (Pearson’s coefficient -0.276) and positively with GAES (Pearson’s co-efficient 0.180). For categories, angiography had 66/154 (42.9%) normal and 88/154 (57.1%) abnormal results. SYNTAX score had 134/154 (87.0%) low-risk and 20/154 (13.0%) medium-high-risk categories. GAES correlated positively with angiogram results (Spearman’s coefficient 0.298) and SYNTAX categories (Spearman’s coefficient 0.110). LVEF% correlated negatively with angiogram results (Spearman’s coefficient -0.307) and SYNTAX categories (Spearman’s coefficient -0.254).

Conclusions

The distribution of underlying atherosclerotic vessels resulted in regional wall abnormalities being more significant than global function on 2D-echocardiography. We conclude that basic 2D-echocardiography remains useful in CAD screening.

Modern Medicine – Issue 6 2022