Evaluating Basic Two-Dimensional Echocardiography For Screening In Coronary Artery Disease

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Abstract 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 had >50% 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.

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