Author + information
- Received April 23, 1991
- Revision received November 20, 1991
- Accepted December 5, 1991
- Published online May 1, 1992.
- Stephen G. Sawada, MD, FACC∗,
- Thomas Ryan, MD, FACC,
- Douglas Segar, MD, FACC,
- Lawrence Atherton, MD,
- Naomi Fineberg, PhD,
- Cris Davis, BS and
- Harvey Feigenbaum, MD, FACC
- ↵∗Address for reprints: Stephen G. Sawada, MD, University Hospital, Room 5420, 926 West Michigan Street, Indianapolis, Indiana 46202.
Transthoracic echocardiographic examination of the proximal left coronary system was performed in 59 patients who had dilated cardiomyopathy to determine if this technique could distinguish between ischemic and nonischemic dilated cardiomyopathy. With use of annular array transducers (3.5 or 5 MHz) and digital image processing, echocardiographic visualization of the coronary arteries was successful in 55 (93%) of 59 patients. As assessed by coronary angiography, 32 subjects had ischemic cardiomyopathy and 27 had nonischemic cardiomyopathy.
Twenty-seven (84%) of the 32 patients who had coronary artery disease and 24 (89%) of the 27 patients with nonischemic cardiomyopathy were correctly identified. The accuracy of coronary echocardiography was 86% in the entire study group and 93% when patients with inadequate studies were excluded. All subjects who had ischemic cardiomyopathy had evidence of disease by coronary echocardiography or segmental wall motion abnormalities. Multivariate analysis permitted correct classification of 93% of all subjects based on the results of the coronary echocardiogram, evaluation of segmental wall motion and a history of prior myocardial infarction. The correct diagnosis was made in 86% when the results of coronary echocardiography were excluded from analysis using all other echocardiographic and clinical variables.
Transthoracic coronary echocardiography can be performed with a high degree of success in patients with dilated ventricles and the technique can reliably distinguish between ischemic and nonischemic dilated cardiomyopathy.
☆ This study was supported in part by the Herman C. Krannert Fund, Indianapolis: Grants HL-06308 and HL-07182 from the National Heart, Lung, and Blood Institute of the National Institutes of Health, Bethesda, Maryland: U.S. Public Health Service, Bethesda and the American Heart Association, Indiana Affiliate, Inc., Indianapolis.
- Received April 23, 1991.
- Revision received November 20, 1991.
- Accepted December 5, 1991.