Prevalence of carotid atherosclerosis in patients with coronary artery disease

Many studies have identified the relationship between carotid atherosclerosis and coronary artery diseases. The rationale for testing carotid artery stenosis in patients with coronary artery disease, have several benefits for early detection of asymtomatic carotid stenosis. The aim of this study is to evaluate the prevalence of carotid artery patients with coronary artery disease. The study included 102 patients proved to be ischemic heart disease angiography, underwent carotid duplex. These patients classified into two groups according to carotid duplex result, group A [negative duplex] and group B [positive carotid duplex]. All patients were subjected to the following:-Full history taking, thorough clinical examination, laboratory investi-gation, 12 leads surface ECG, echocardiography, coronary angiography and carotid duplex. Age was significantly higher in group B than in group A. No statistically significant difference between both groups as regard EF% and history of myocardial infarction. There was close association between carotid atherosclerosis and multivessel coronary artery disease. Carotid atherosclerosis and degree of stenosis in. left carotid artery was significantly higher than in right one. From this study we concluded that there was a close relationship between coronary and carotid atherosclerosis both sharing more or Less, the same risk factors [smoking, diabetes mellitus, hypertension, hyperlipidemia and left ventricular hypertrophy], the degree of carotid atherosclerosis can be used as non invasive procedure for assessment of patients prepared for coronary angiogram

Impact of doppler tissue imaging in the assessment of regional wall motion abnormalities in patients with old myocardial infarction

Doppler Tissue Imaging [DTI] is an emerging non-invasive ultrasound technique, which allows measuring velocities at any point of the ventricular wall during the cardiac cycle.To evaluate the clinical feasibility of DTI as a new method for detection and quantification of regional Wall Motion Abnormalities [WMA] in patients with old Myocardial Infarction [MI].Fourty patients with old MI who had angiographically-documented significant stenotic lesion in the infarct-related artery and WMA in the infarcted area were evaluated in addition to twenty healthy subjects[control group].Regional wall motion of each of the anterior and inferior wall segments of the left ventricle was assessed by conventional 2-D echocardiography and pulsed wave DTI. The later includes the measurement of Peak Myocardial Velocity [PMV] and Myocardial Velocity Gradient [MVG].The peak MV and MVG in the studied myocardial segments of control subjects ranged between 4 to 15 cm/s and 1 to 3.85 cms.[-l] respectively. In patients group, Myocardial segments supplied by diseased coronary vessel in the infarcted area were found to have highly significant reduction of both MV and MVG compared to the same segments in control subjects [p<0.001]. The sensitivity for detection of WMA was markedly improved by DTI studies [92.5% for MV and 100% for MVG versus 52.5% for 2-D echo] with retaining the high specificity inherited by conventional echocardiography .Compared to conventional 2-D echo, pulsed wave DTI is an accurate, highly sensitive non-invasive method to detect and quantify regional WMA induced by coronary artery disease. It is almost as accurate as contrast ventriculography in this regard, so it may be the best imaging technique for detection of WMA at rest and with different cardiovascular stresses

Feasibility and accuracy of acoustic quantification and color kinesis in assesment of regional and global systolic left ventricular function in patient with coronary artery disease

The analysis of segmental wall motion using two-dimentional [2-D] echocardioglaphy is subjective with inter-obsever variability.Color kinesis is new technique providing color-encoded map of endocardial motion. We evaluated the accuracy of Acoustic Quantification [AQ] and 2-D for assessment of global and regional LV systolic function compared with LV angiography as a reference method. Forty ischemic heart patients who underwent coronary angiography were included in this study in addition to 10 healthy control subjects. Control subjects and patients were evaluated by 2-D, AQ and color kinesis echocardiography. Coronary Angiography and LV angiography were done for ischemic heart patients. Regional wall motion pattern [normal, hypokinesis, Akinesis, dyskinesis as well as EF were determined. Accuracy of AQ color kinesis and 2-D were evaluated and compared to LV angiography. LVEF measured by 2-D and color kinesis were closely correlated with that estimated from contrast LV angiography ventriculography[r= 0.95 and r= 0.97 respectively]. Color kinesis compared to 2-D, enhance the accuracy of EF measurements.In control subjects there was a very close agreement of 2-D and color kinesis as regard the pattern of regional wall motion. In patients group, color kinesis was significantly better than 2-D on the definition of normal versus abnormal segments [95.2% of segments correctly evaluated by color kinesis versus 86.1% by 2-D, p < 0.05]. Color kinesis is a new echocardiographic technique that provide more accurate semiquantitative assessment of regional wall motion abnormalities. Additionally, AQ is a convenient method for better measurement of EF