Author + information
- Received May 28, 1985
- Revision received August 20, 1985
- Accepted September 27, 1985
- Published online February 1, 1986.
- Thomas E. Capannari, MD,
- Stephen R. Daniels, MD, MPHb,
- Richard A. Meyer, MD, FACC,
- David C. Schwartz, MD, FACC and
- Samuel Kaplan, MD, FACCa
- ↵aAddress for reprints: Samuel Kaplan, MD, Director, Division of Cardiology, Children's Hospital Medical Center, Elland and Bethesda Avenues, Cincinnati, Ohio 45229.
Seventy-seven patients with Kawasaki disease were prospectively evaluated from 1978 to 1983 to determine the sensitivity, specificity and predictive value for detecting coronary artery aneurysms with two-dimensional echocardiography. Seventy (91%) underwent selective coronary arteriography and are included in this report. The study was divided into two periods because of increased experience and the use of a systematic approach with two-dimensional echocardiography in the second period as compared with the first. Aneurysms were demonstrated in nine patients (13%).
The coronary artery system was divided into six regions: proximal third of the main right coronary artery, distal right coronary artery, left main coronary artery, left anterior descending coronary artery, circumflex coronary artery and distal left coronary artery. The sensitivity and specificity were high when imaging the proximal regions, and improved from the first period to the second. Both sensitivity and specificity were lower for the more distal regions of the right and left coronary arteries. Overall, the sensitivity of two-dimensional echocardiography was 100% because there were no patients in our study who had isolated distal coronary artery aneurysms. Two-dimensional echocardiography is a sensitive and specific test for detecting aneurysms in the proximal portions of both the right and left coronary arteries, and is useful in selecting patients for invasive investigation with selective coronary arteriography.
↵b Dr. Daniels is the recipient of Public Health Service Clinical Investigator Award HL01380 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland.
This work was presented in part at the 34th Annual Scientific Session of the American College of Cardiology, Anaheim, California, March 1985.
- Received May 28, 1985.
- Revision received August 20, 1985.
- Accepted September 27, 1985.
- American College of Cardiology Foundation