Interventricular septal motion in patients with proximal and distal left anterior descending coronary artery lesions.

Gordon, M.; Kerber, Richard E.

doi:10.1161/01.cir.55.2.338

Cited by 39 publications

(2 citation statements)

References 16 publications

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“…'3 The usefulness of the echocardiogram in predicting the location of the LAD lesion is controversial.8' 24 This study does not show a relationship between AESM and the location of the disease proximal to the first septal perforator and is in agreement with a recent publication by Gordon and Kerber.24 In our study, it was not the location of the left anterior lesions, but the presence of a perfusion defect that was best related to echocardiographic septal motion.…”

Section: Discussionsupporting

confidence: 87%

The relationship between abnormal echocardiographic septal motion and myocardial perfusion in patients with significant obstruction of the left anterior descending artery.

Kolibash¹,

Beaver²,

Fulkerson³

et al. 1977

Circulation

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This study assesses the relationship between segmental myocardial function and coronary perfusion in patients with high-grade stenosis of the left anterior descending artery. Twenty-five patients with critical lesions (> 70%) were divided into two groups according to the absence or presence of normal echocardiographic septal motion. Twelve patients had abnormal echocardiographic septal motion (AESM) and 13 patients had normal septal motion. Septal perfusion was evaluated by intracoronary injections of radiolabeled macroaggregated albumin (MAA) particles. Of the parameters analyzed abnormal septal perfusion was best related to AESM. Among the 12 patients with AESM, ten had absent resting septal perfusion. Of the 13 patients with normal septal ECHOCARDIOGRAPHY HAS NOW BECOME a useful and accepted noninvasive procedure for evaluating left ventricular performance.' Although the procedure has been most helpful in assessing left ventricular function when the ventricle is diffusely diseased, the echocardiogram is also of proven benefit in defining abnormal contractility in patients with coronary artery disease.8 '0 However, since all segments of the ventricle are not accessible by echocardiography and since coronary disease may produce segmental ventricular dysfunction, it is not always possible to detect all diseased segments of the ventricle. On the other hand, the echocardiogram can provide useful information regarding the interventricular septum, a structure which is not easily evaluated by conventional angiographic techniques."' 12 An important and common cause of abnormal echocardiographic septal motion (AESM) is high grade obstruction of the left anterior descending artery.5' 10, 13 This abnormality of the septum when seen in the presence of significant obstruction of the left anterior descending would seem to imply myocardial ischemia and/or infarction or fibrosis of the septum. A recent report which includes pathological studies related septal thinning to scarring of the septum.'2 Some authors have further suggested that AESM implies not only a critical left anterior descending lesion, but that the lesion is proximal to the first septal perforator branch.10 13Despite the usefulness of coronary angiography in defining the presence of significant obstruction of the major coronary arteries, the procedure does not allow visualization of small vessels and therefore does not provide complete information concerning resting myocardial perfusion. motion, only two had abnormal septal perfusion. Septal width was also significantly thinner in patients with AESM. When angiographic collateralization was associated with septal perfusion as detected by injection of MAA into the right coronary artery, normal septal motion was present (five patients). When no septal perfusion resulted from right coronary injection, even though collaterals were seen angiographically, AESM was found (four patients). Thus, in patients with severe left anterior descending stenosis the presence of abnormal echocardiographic septal motion strongly sug...

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Section: Discussionsupporting

confidence: 87%

The relationship between abnormal echocardiographic septal motion and myocardial perfusion in patients with significant obstruction of the left anterior descending artery.

Kolibash¹,

Beaver²,

Fulkerson³

et al. 1977

Circulation

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“…Echocardiographic evaluation of systolic motion of the interventricular septum has been suggested as a noninvasive means of detecting stenosis of LMCA or LAD proximal to the first septal branch (proximal LAD) (Joffe et al., 1977). Others have also found diminished septal motion in patients with LMCA or LAD disease, but with relative low sensitivity and with limited ability to specifically predict proximal LAD lesions (Gordon & Kerber, 1977). Recently, both a low sensitivity and 'Dr Andersen was recipient of a fellowship from the Norwegian Council on Cardiovascular Diseases.…”

Section: Introductionmentioning

confidence: 99%

Left main or proximal left anterior descending coronary artery disease: detection by echocardiographic evaluation of interventricular septal function during exercise

Andersen

Vik‐Mo

Hoff

1986

Clinical Physiology

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Forty patients with coronary artery disease were studied prospectively to investigate whether stenosis of the left main (LMCA) or left anterior descending coronary artery, proximal to the first septal branch (proximal LAD), could be detected by M-mode echocardiography during exertion. The interventricular septum was visualized in 30 of the patients during bicycle exercise in the semisupine position, all with simultaneous occurrence of electrocardiographic evidence of myocardial ischaemia. Fifteen of these had LMCA or proximal LAD stenosis. Systolic motion and thickening of the septum decreased significantly from rest to peak exercise in patients with LMCA or proximal LAD disease while it increased in those without. The results suggest that M-mode echocardiography during exercise in patients with coronary artery disease might identify those with LMCA or proximal LAD stenosis.

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Natural history of left anterior descending coronary artery obstruction: Significance of location of stenoses in medically treated patients

Samaha

Connor

Tribble

et al. 1985

Clinical Cardiology

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Summary:We examined the prognostic significance of an obstmctive lesion in the proximal left anterior descending (LAD) coronary artery. Five-year or longer followup data were examined from 3 1 1 patients with > 70 % obstruction of the LAD treated without surgery. Mortality was compared in subsets with lesions proximal to and distal to the first septal perforating artery. Survival curves were worse in patients with proximal than with distal LAD disease (p <0.05); lesion location remained a significant determinant of survival when ejection fraction, age, and sex were controlled using a Cox regression model. However, when patient subsets were examined, survival with proximal LAD disease was worse than with distal obstruction only in the presence of an associated right coronary artery lesion and an ejection fraction of less than 40% (p

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Interventricular septal motion in patients with proximal and distal left anterior descending coronary artery lesions.

Cited by 39 publications

References 16 publications

The relationship between abnormal echocardiographic septal motion and myocardial perfusion in patients with significant obstruction of the left anterior descending artery.

The relationship between abnormal echocardiographic septal motion and myocardial perfusion in patients with significant obstruction of the left anterior descending artery.

Left main or proximal left anterior descending coronary artery disease: detection by echocardiographic evaluation of interventricular septal function during exercise

Natural history of left anterior descending coronary artery obstruction: Significance of location of stenoses in medically treated patients

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