Coronary Artery Wall Thickness of the Left Anterior Descending Artery Using High Resolution Transthoracic Echocardiography – Normal Range of Values

Abstract

Recently it has been demonstrated that high resolution transthoracic echocardiography (HRTTE) is able to detect differences in the wall thickness of the left anterior descending coronary artery (LAD) between patients with coronary artery disease (CAD) and normal volunteers. We sought to validate this technique, develop a normal range of values and demonstrate the test-retest variability of each measurement. Two hundred forty-two volunteer participants had a HRTTE study to measure their LAD wall thickness, luminal, and external diameters. Thirty of these subjects had these measurements taken on 3 separate occasions by 2 different echosonographers. All subjects were free of clinical CAD, hypertension, hyperlipidemia, and diabetes mellitus. The average anterior wall thickness was 1.1 ± 0.2 mm; posterior wall thickness was 1.1 ± 0.2 mm, luminal diameter 2.2 ± 0.6 mm, and external elastic membrane (EEM) diameter 4.5 ± 0.9 mm. The bias of the measurements within the same operator for LAD wall thickness, luminal diameter, and EEM was 0.042, -0.06, and -0.077 mm, respectively. The bias of the measurements between 2 different operators for LAD wall thickness, luminal diameter, and EEM was 0.082, -0.077, and -0.027 mm, respectively. In conclusion, HRTTE measurement of the LAD vessel is reproducible within and between operators in normal volunteers. This technique therefore warrants further study as a potential screening modality for subclinical coronary atherosclerosis.

The effects of clinically‐derived parametric data uncertainty in patient‐specific coronary simulations with deformable walls

“…The lumen diameter of the left main coronary is 4 mm and the diameter of the distal left anterior descending artery (LAD) is 2.7 mm, consistent with the range of diameters on normal human left coronaries, the proximal LAD diameter d = 3.7 ± 0.4 mm, and distal LAD d = 1.9 ± 0.4 mm. 41,42 The wall structural mesh was obtained using a uniform wall thickness h = 0.08 mm ( Figure 2). The coronary wall thickness is consistent with two electrocardiographic studies that consistently reported a coronary wall thickness of 1.0 ± 0.2 mm 42,43 and with the morphometric law for coronary vessel thickness by Podesser, 44 and larger than a typical vessel wall thickness equal to 10% of the vessel radius found in the literature.…”

“…41,42 The wall structural mesh was obtained using a uniform wall thickness h = 0.08 mm ( Figure 2). The coronary wall thickness is consistent with two electrocardiographic studies that consistently reported a coronary wall thickness of 1.0 ± 0.2 mm 42,43 and with the morphometric law for coronary vessel thickness by Podesser, 44 and larger than a typical vessel wall thickness equal to 10% of the vessel radius found in the literature. [45][46][47][48][49] Interaction between fluid and structure is simulated through Arbitrary Lagrangian-Eulerian (ALE) coupling provided by the SimVascular svFSI solver, which implements a variational multi-scale finite element method with second order implicit generalized-α time integration.…”

Objective Uniaxial Identification of Transition Points in Non-Linear Materials: Sample Application to Porcine Coronary Arteries and the Dependency of Their Pre- and Post-Transitional Moduli with Position

“…Leung et al [34] other comparisons are hard to make since the location of the distal section is not always clear [36]. Measurements might also vary between human [33] and porcine specimens.…”

Fluid-Structure Interaction Analysis for Drug Transport in a Curved Stenotic Right Coronary Artery

“…The normal diameter is about 3.21 mm, the diameter of stenotic area is 1.43 mm, and the wall thickness is 1 mm [14] [15].…”