Usefulness of two-dimensional echocardiography in the diagnosis of severe coronary stenosis in patients with non-ST-segment elevation acute coronary syndrome




Liliam G. Cisneros-Sánchez, Unidad de Cuidados Coronarios, Hospital General Docente Enrique Cabrera, La Habana, Cuba
Geovedy Martínez-García, Unidad de Cuidados Coronarios, Hospital General Docente Enrique Cabrera, La Habana, Cuba
Lázaro Puig-Benítez, Unidad de Cuidados Coronarios, Hospital General Docente Enrique Cabrera, La Habana, Cuba
Annia M. Carrero-Vázquez, Unidad de Cuidados Coronarios, Hospital General Docente Enrique Cabrera, La Habana, Cuba
Rosa Ma. Martínez-Peró, Unidad de Cuidados Coronarios, Hospital General Docente Enrique Cabrera, La Habana, Cuba
Taimara Pérez-Rivero, Unidad de Cuidados Coronarios, Hospital General Docente Enrique Cabrera, La Habana, Cuba


Introduction: Echocardiography in patients who suffer from non-ST-segment elevation acute coronary syndrome (NSTE-ACS) can detect the location and extent of wall motion abnormalities and thus infer the severity of coronary lesions. Objective: To determine the validity of the two-dimensional echocardiography in the diagnosis of severe coronary stenosis (SCS) in patients with NSTE-ACS. Method: An observational, analytical, cross-sectional study in 108 patients with NSTE-ACS was conducted. An echocardiogram was performed prior to coronary angiography. Subsequently, concordance between both tests was sought and the validity and safety of the echocardiogram in the diagnosis of SCS was determined. Results: Sensitivity was 61.7%, specificity 64.29%, positive predictive value (PPV) 92.06%, and negative predictive value 20%. Sensitivity decreased as the number of severely injured coronary arteries increased, while specificity increased (97.06% in three-vessel disease). Conclusions: The echocardiogram didn’t have high sensitivity or specificity in the diagnosis of SCS; however, in the presence of altered regional contractility, the existence of an ECS due to high PPV is highly likely. Specificity was high for three-vessel disease, so it could help exclude this entity.



Keywords: Two-dimensional echocardiography. Non-ST-segment elevation acute coronary syndrome. NSTE-ACS. Coronary stenosis.