Objective: To determined Relationship between the incidence, location and extent of atherosclerosis in the thoracic aorta seen on transesophageal echocardiography (TEE) and the extent of coronary artery disease (CAD).
Methods: The study population consisted of 188 TEE patients who also underwent coronary angiography. Atherosclerotic plaques seen on TEE were defined as (1) complex plaques in the presence of protruding atheroma >4 mm thickness, mobile debris, or plaque ulceration, or (2) simple plaques in the absence of findings consistent with complex plaques. The extent of CAD was grouped into four groups according to the number of coronary vessels with ≥70% stenosis.
Results: The number of patients with 0, 1, 2, and 3 coronary vessel diseases were 99, 31, 28, and 30 respectively. Compared to patients without CAD, patients with CAD (n=89) had a significantly greater prevalence of aortic atherosclerotic plaques, irrespective of the degree of plaque complexity or location (p<0.05). Multivariate analysis found that hypertension, diabetes mellitus, and aortic plaque were significantly associated with CAD. There was a significant relationship between simple and complex aortic plaques and the increasing severity of CAD (p<0.001). Multivariate logistic regression analysis showed that the complex plaque in the descending aorta (Odds ratio, 5.4; 95%CI, 1.8 to 16.4; p=0.003) was the strongest predictor of CAD.
Conclusion: Both simple and complex thoracic atherosclerotic plaques detected by TEE are associated with the increasing severity of CAD. Complex plaque in the descending aorta was the strongest associated with the presence of CAD.