Grade of aortic atherosclerosis: A valuable adjunct to coronary flow velocity reserve in the evaluation of coronary artery disease

Abstract

Background: Atherosclerosis is a generalized disease of the arterial vasculature; among thus it manifests in the descending aorta and the coronary arteries. We tested whether known risk factors, the coronary flow velocity reserve and the grade of aortic atherosclerosis detected by transoesophageal echocardiography in the course of the same semi-invasive examination is able to distinguish between patients with significant left anterior descending coronary artery (LAD) stenosis or with multivessel disease. Methods and results: The present study involved 125 consecutive patients (mean age: 56±11 years, range: 22-73) with chest pain undergoing coronary angiography. Grade of aortic atherosclerosis was obtained by means of transoesophageal echocardiography, and the coronary flow velocity reserve was calculated in the left anterior descending coronary artery. The age (ROC area, 63%, p<0.01), the gender (ROC area, 63%, p<0.02) and the grade of aortic atherosclerosis (ROC area, 64%, p<0.01) exhibited good power for the prediction of patients with multivessel disease from among all other patients. Only the grade of aortic atherosclerosis (ROC area, 63%, p<0.05) appears useful to distinguish patients with left anterior descending coronary artery disease from those with multivessel disease. Conclusions: These results demonstrate that grade of aortic atherosclerosis furnishes additional help in the prediction of patients with severe coronary artery disease. It can differentiate patients with multivessel disease from those with significant left anterior descending coronary artery stenosis. Coronary flow velocity reserve has no any prognostic power in this evaluation.