Is imaging the left main able to rule out severe LAD stenosis?

摘要： <正> The 5-year cardiac mortality rate has been reported to be more than 50% in patients with leftmain coronary artery (LMCA) stenosis.The purpose of this study was to visualize the LMCA using intravascularultrasound in patients who undergo interventions of the left anterior descending coronary artery (LAD).This wasdone in order to see the incidence and severity of plaque formation in the LMCA in patients with severe LADstenesis,and to address if scanning LMCA is able to rule out LAD significant stenosis or vice versa.Methods Atotal of 293 patients with intervention of the LAD stenosis were examined with intravascular ultrasound(IVUS).Theimages of 278 patients were suitable for analysis.Results Fifty-three (19%) were found to have angiographielumen reduction in the LMCA ranging from 11% to 35% (19±8%).Sixty-one patients were found to have nativecalcification in the LMCA.Atherosclerotic plaques in LMCA were detected in 211/278 (76%) patients,of which164/211 (78%) were eccentric,and 51/211 (24%) had calcium deposit.The cross-sectional plaque area rangedfrom 1.5 mm~2 to 21 mm~2 (8.4±4.7 mm~2).Area of stenusis was 34±14% (8-66%) and diameter of stenosis was21±8% (7-42%).A weak relationship concerning severity of stenosis between LAD stenosis and LMCA stenosiswas found in the 59 patients with pre-interventional IVUS examinations (r=0.47,P<0.05).ConclusionsLMCA is frequently involved with atherosclerotic lesions in patients with severe LAD stenosis.A weak relationshipdoes exist concerning the severity of stenosis between LAD and LMCA.However,IVUS for LMCA lesion is not ableto rule out lAD stenosis.(J Ceriatr Cardiol 2004;1:35-39.) ... （共5頁）