Relationship of atherosclerotic plaque of aorta detected by transesophageal echocardiography and the severity of coronary artery disease

Objective To determine whether simple or complex aortic plaques seen on transesophageal echocardiograpy (TEE) correlated with the extent,Iocation and severity of aortic atherosclerosis with 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 0A stenosis.The patients were divided into 4 groups according to this too.Group A was patients with 0 vessel diseases and the number were 99,Group B was patients with 1 vessel diseases and the number were 31,Group C was patients with 2 vessel diseases and the number were 28,Group D was patients with 3 vessel diseases and the number were 30.Results Compared to group A,patients with CAD (including group B,C and D)had a significantly greater prevalence of aortic atheroselerotic plaques.irrespective of the degree of plaque complexity or location(P＜0.05).Multivariate analysis found that hypertension(odds ratio 3.0,95%CI 1.3 to 7.0,P=0.013),diabetes mellitus(odds ratio 2.4,95%CI 1.1 to 4.9,P=0.022)and aortic plaque(odds ratio 3.8,95%CI 1.8 to 8.2,P=0.001)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.Conclusions 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. Key words: Eehocardiography; transesophageal; Aorta; Atherosclerosis; Coronary disease